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Eclectic Family Pharmacy, Inc.

Details

Name: Eclectic Family Pharmacy, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 15 Jul 1998 (26 years ago)
Entity Number: 000-196-734
Register Number: 000196734
County: Elmore
Place of Formation: Elmore County
Principal Address: WETUMPKA, AL
Registered Office Street Address: 9845 GEORGIA RDWETUMPKA, AL 36092
Registered Office Street Address ZIP Code: 36092
Authorized Capital: $100

Activities WHOLESALE/RETAIL SALES OF PHARMACEUTICAL AND RELATED PRODUCTS

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1205905155 2006-11-07 2017-02-21 PO BOX 240519, ECLECTIC, AL, 360240020, US 575 CLAUD RD, STE 2000, ECLECTIC, AL, 360246318, US

Contacts
Phone +1 334-541-2522
Fax 3345414436

Authorized person
Name TERESA LETT
Role PHARMACY OWNER
Phone 3345412522

Taxonomy
Taxonomy Code 333600000X - Pharmacy
Is Primary No
Taxonomy Code 3336C0003X - Community/Retail Pharmacy
License Number 111326
State AL
Is Primary Yes

Other Provider Identifiers
Issuer PK
Number 1993665
Issuer MEDICAID
Number 100003024
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ECLECTIC FAMILY PHARMACY, INC. 401(K) PLAN 2022 631205079 2023-12-01 ECLECTIC FAMILY PHARMACY, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 446110
Sponsor’s telephone number 3345414433
Plan sponsor’s address 575 CLAUD RD, ST. 2000, ECLECTIC, AL, 36024

Signature of
Role Plan administrator
Date 2023-12-01
Name of individual signing TERESA LETT
Role Employer/plan sponsor
Date 2023-12-01
Name of individual signing TERESA LETT
ECLECTIC FAMILY PHARMACY, INC. 401(K) PLAN 2022 631205079 2023-05-25 ECLECTIC FAMILY PHARMACY, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 446110
Sponsor’s telephone number 3345412522
Plan sponsor’s address 575 CLAUD RD, ST. 2000, ECLECTIC, AL, 36024

Signature of
Role Plan administrator
Date 2023-05-25
Name of individual signing TERESA LETT
Role Employer/plan sponsor
Date 2023-05-25
Name of individual signing TERESA LETT
ECLECTIC FAMILY PHARMACY, INC. 401(K) PLAN 2021 631205079 2022-06-01 ECLECTIC FAMILY PHARMACY, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 446110
Sponsor’s telephone number 3345414433
Plan sponsor’s address 575 CLAUD ROAD, ST. 2000, ECLECTIC, AL, 36024

Signature of
Role Plan administrator
Date 2022-06-01
Name of individual signing TERESA LETT
Role Employer/plan sponsor
Date 2022-06-01
Name of individual signing TERESA LETT
ECLECTIC FAMILY PHARMACY, INC. 401(K) PLAN 2020 631205079 2021-08-09 ECLECTIC FAMILY PHARMACY, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 446110
Sponsor’s telephone number 3345414433
Plan sponsor’s address 575 CLAUD RD., SUITE 2000, ECLECTIC, AL, 36024

Signature of
Role Plan administrator
Date 2021-08-09
Name of individual signing TERESA LETT
Role Employer/plan sponsor
Date 2021-08-09
Name of individual signing TERESA LETT
ECLECTIC FAMILY PHARMACY, INC. 401(K) PLAN 2019 631205079 2020-09-01 ECLECTIC FAMILY PHARMACY, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 446110
Sponsor’s telephone number 3345414433
Plan sponsor’s address 575 CLAUD RD,, SUITE 2000, ECLECTIC, AL, 36024

Signature of
Role Plan administrator
Date 2020-09-01
Name of individual signing TERESA LETT
Role Employer/plan sponsor
Date 2020-09-01
Name of individual signing TERESA LETT
ECLECTIC FAMILY PHARMACY, INC. 401(K) PLAN 2018 631205079 2020-09-01 ECLECTIC FAMILY PHARMACY, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 446110
Sponsor’s telephone number 3345414433
Plan sponsor’s address 575 CLAUD RD., SUITE 2000, ECLECTIC, AL, 36024

Signature of
Role Plan administrator
Date 2020-09-01
Name of individual signing TERESA LETT
Role Employer/plan sponsor
Date 2020-09-01
Name of individual signing TERESA LETT
ECLECTIC FAMILY PHARMACY INC 401(K) PLAN 2017 631205079 2018-07-17 ECLECTIC FAMILY PHARMACY INC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 446110
Sponsor’s telephone number 3345414433
Plan sponsor’s address PO BOX 240519, ECLECTIC, AL, 36024

Signature of
Role Plan administrator
Date 2018-07-17
Name of individual signing TERESA L LETT
ECLECTIC FAMILY PHARMACY INC 401(K) PLAN 2016 631205079 2017-07-26 ECLECTIC FAMILY PHARMACY INC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 446110
Sponsor’s telephone number 3345414433
Plan sponsor’s address PO BOX 240519, ECLECTIC, AL, 36024

Signature of
Role Plan administrator
Date 2017-07-26
Name of individual signing TERESA L LETT
ECLECTIC FAMILY PHARMACY INC 401(K) PLAN 2015 631205079 2016-09-19 ECLECTIC FAMILY PHARMACY INC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 446110
Sponsor’s telephone number 3345414433
Plan sponsor’s address PO BOX 240519, ECLECTIC, AL, 360240020

Signature of
Role Plan administrator
Date 2016-09-19
Name of individual signing TERESA L LETT
Role Employer/plan sponsor
Date 2016-09-19
Name of individual signing TERESA L LETT
ECLECTIC FAMILY PHARMACY INC 401K PLAN 2014 631205079 2015-08-14 ECLECTIC FAMILY PHARMACY INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 446110
Sponsor’s telephone number 3345414433
Plan sponsor’s address PO BOX 240519, ECLECTIC, AL, 360240020

Signature of
Role Plan administrator
Date 2015-08-14
Name of individual signing TERESA L LETT
Role Employer/plan sponsor
Date 2015-08-14
Name of individual signing TERESA L LETT

Agent

Name Role
CAROTHERS, TERESA L Agent

Incorporator

Name Role
CAROTHERS, TERESA L Incorporator

Related by officers

No related officers

Related by address

WETUMPKA, AL

Bama Wood, Inc. Campbell-Brown Service, Inc. Elmore County Farmers Exchange, Inc. Central Auto Parts, Inc. N-D & M Contractors, Inc. Perkins Warehouse and Gin, Inc. Strickland Brothers, Inc. Turner Auto Supply Company Wetumpka Herald, Inc. Collier Ford, Inc.

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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