| Name: | Haleyville Medical Arts Drugs, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 30 Jun 1995 (29 years ago) (Companies founded in June 1995) |
| Date of dissolution: | 28 Dec 2018 |
| Entity Number: | 000-172-822 |
| Register Number: | 000172822 |
| ZIP code: | 35565 (Companies in Winston, 35565) |
| County: | Winston |
| Place of Formation: | Winston County |
| Principal Address: | HALEYVILLE, AL |
| Registered Office Street Address: | HWY 195 EHALEYVILLE, AL 35565 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | ---- |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740225622 | 2006-06-17 | 2018-07-19 | PO BOX 575, HALEYVILLE, AL, 355650575, US | 42322 HIGHWAY 195, HALEYVILLE, AL, 355657064, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 205-486-3133 |
| Fax | 2054868966 |
Authorized person
| Name | LEAH BUTLER |
| Role | PRESIDENT/PIC/AO |
| Phone | 2054863133 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 106610 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 100001802 |
| State | AL |
| Issuer | PK |
| Number | 2142930 |
| Name | Role | Address |
|---|---|---|
| MORRIS, JONATHAN | Agent | 2257 GOVERNORS BEND RD SEHUNTSVILLE, AL 35801 |
| Name | Role | Address |
|---|---|---|
| MORRIS, JONATHAN | Incorporator | 2257 GOVERNORS BEND RD SEHUNTSVILLE, AL 35801 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
