Name: | Southeast Pharmaceuticals, Inc. |
Jurisdiction: | Alabama |
Legal type: | Domestic Corporation |
Status: | Exists |
Date of registration: | 17 Jan 1995 (30 years ago) (Companies founded in January 1995) |
Entity Number: | 000-169-541 |
Register Number: | 000169541 |
ZIP code: | 36323 (Companies in Coffee, 36323) |
County: | Coffee |
Place of Formation: | Coffee County |
Principal Address: | ELBA, AL |
Registered Office Street Address: | 704-A TROY HWYELBA, AL 36323 |
Authorized Capital: | $100 |
Paid Share Capital: | $100 |
Activities
COMPLETE PHARMACEUTICAL RELATED CARE SERVICES
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1518054816 | 2006-10-06 | 2011-11-30 | PO BOX 415, ELBA, AL, 363230415, US | 704 TROY HWY, STE A, ELBA, AL, 363231521, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Phone | +1 334-897-3746 |
Fax | 3348973716 |
Authorized person
Name | MR. JOHN NEAL HOLLEY |
Role | PRESIDENT |
Phone | 3348973746 |
Taxonomy
Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
License Number | 027146 |
State | AL |
Is Primary | No |
Taxonomy Code | 332BC3200X - Customized Equipment (DME) |
License Number | 027146 |
State | AL |
Is Primary | No |
Taxonomy Code | 332BP3500X - Parenteral & Enteral Nutrition Supplies (DME) |
License Number | 027146 |
State | AL |
Is Primary | No |
Taxonomy Code | 332BX2000X - Oxygen Equipment & Supplies (DME) |
License Number | 027146 |
State | AL |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 106273501 |
State | FL |
Issuer | MEDICAID |
Number | 009505350 |
State | AL |
Issuer | BCBS |
Number | 510-36152 |
State | AL |
Name | Role |
---|---|
HOLLEY, JOHN NEAL | Incorporator |
HOLLEY, MARY HARMON | Incorporator |
HOLLEY, JIMMY WALLACE | Incorporator |
Name | Role | Address |
---|---|---|
HOLLEY, JOHN N | Agent | 404 SPRINGDALE DRIVEENTERPRISE, AL 36330 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State