| Name: | Freeman Pharmacy Incorporated |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 23 Feb 1998 (27 years ago) |
| Entity Number: | 000-193-878 |
| Register Number: | 000193878 |
| County: | Macon |
| Place of Formation: | Macon County |
| Registered Office Street Address: | 114 S MAIN STREETTUSKEGEE, AL 36083 |
| Registered Office Street Address ZIP Code: | 36083 |
| Authorized Capital: | $100 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760547301 | 2006-12-26 | 2014-11-04 | 209 W. MLK HWY., SUITE D, TUSKEGEE, AL, 36083, US | 209 W MLK HWY, SUITE D, TUSKEGEE, AL, 36083, US | |||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 334-727-0047 |
| Fax | 3347270886 |
Authorized person
| Name | MR. MARK FREEMAN |
| Role | OWNER/PHARMACIST |
| Phone | 3347270047 |
Taxonomy
| Taxonomy Code | 183500000X - Pharmacist |
| License Number | 12782 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 12782 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MASS IMMUNIZATION PTAN |
| Number | 510G730009 |
| Issuer | MEDICAID |
| Number | 009910826 |
| State | AL |
| Name | Role |
|---|---|
| FREEMAN, MARKEL | Agent |
| Name | Role |
|---|---|
| FREEMAN, MARK K | Director |
| FREEMAN, RENEE | Director |
| Name | Role |
|---|---|
| FREEMAN, MARKEL | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
