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Marble City Pharmacy, Inc.

Details

Name: Marble City Pharmacy, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 07 Feb 2003 (22 years ago) (Companies founded in February 2003)
Entity Number: 000-227-373
Register Number: 000227373
ZIP code: 35150 (Companies in Talladega, 35150)
County: Talladega
Place of Formation: Talladega County
Principal Address: SYLACAUGA, AL
Registered Office Street Address: 264 W FT WILLIAMSSYLACAUGA, AL 35150
Authorized Capital: $1,000

Activities DRUG STORE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1417954488 2005-07-05 2010-12-29 264 W FORT WILLIAMS ST, SYLACAUGA, AL, 351502432, US 264 W FORT WILLIAMS ST, SYLACAUGA, AL, 351502432, US

Contacts
Phone +1 256-245-4446
Fax 2562454484

Authorized person
Name MR. JACOB MILES JOHNSON
Role OWNER
Phone 2562454446

Taxonomy
Taxonomy Code 183500000X - Pharmacist
License Number 112273
State AL
Is Primary Yes
Taxonomy Code 332B00000X - Durable Medical Equipment & Medical Supplies
License Number 112273
State AL
Is Primary No

Other Provider Identifiers
Issuer NABP
Number 0131730
State AL
Issuer MEDICAID
Number 100003479
State AL
Issuer MEDICAID
Number 009932695
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MARBLE CITY PHARMACY 401K PLAN 2023 260057535 2024-05-22 MARBLE CITY PHARMACY 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 446110
Sponsor’s telephone number 2562454446
Plan sponsor’s address 264 W. FORT WILLIAMS ST., SYLACAUGA, AL, 35150

Signature of
Role Plan administrator
Date 2024-05-22
Name of individual signing JARED JOHNSON
MARBLE CITY PHARMACY 401K PLAN 2022 260057535 2023-07-19 MARBLE CITY PHARMACY 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 446110
Sponsor’s telephone number 2562454446
Plan sponsor’s address 264 W. FORT WILLIAMS ST., SYLACAUGA, AL, 35150

Signature of
Role Plan administrator
Date 2023-07-19
Name of individual signing JARED JOHNSON
MARBLE CITY PHARMACY 401K PLAN 2021 260057535 2022-07-25 MARBLE CITY PHARMACY 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 446110
Sponsor’s telephone number 2562454446
Plan sponsor’s address 264 W. FORT WILLIAMS ST., SYLACAUGA, AL, 35150

Signature of
Role Plan administrator
Date 2022-07-25
Name of individual signing JARED JOHNSON
MARBLE CITY PHARMACY (VISION PLAN) 2021 260057535 2022-07-29 MARBLE CITY PHARMACY 7
File View Page
Three-digit plan number (PN) 951
Effective date of plan 2020-10-01
Business code 446110
Sponsor’s telephone number 2059561836
Plan sponsor’s address 264 W. FORT WILLIAMS STREET, SYLACAUGA, AL, 35150

Plan administrator’s name and address
Administrator’s EIN 472506773
Plan administrator’s name KENNION & CO, LLC
Plan administrator’s address 2828 OLD 280 COURT, SUITE 110, VESTAVIA, AL, 35243
Administrator’s telephone number 8669665457

Signature of
Role Plan administrator
Date 2022-07-21
Name of individual signing W. HAL SHEPHERD
Role Employer/plan sponsor
Date 2022-07-21
Name of individual signing W. HAL SHEPHERD
MARBLE CITY PHARMACY (VISION PLAN) 2020 260057535 2021-10-12 MARBLE CITY PHARMACY 0
File View Page
Three-digit plan number (PN) 951
Effective date of plan 2020-10-01
Business code 446110
Sponsor’s telephone number 2059561836
Plan sponsor’s address 264 W. FORT WILLIAMS STREET, SYLACAUGA, AL, 35150

Plan administrator’s name and address
Administrator’s EIN 472506773
Plan administrator’s name KENNION & CO, LLC
Plan administrator’s address 2828 OLD 280 COURT, SUITE 110, VESTAVIA, AL, 35243
Administrator’s telephone number 8669665457

Signature of
Role Plan administrator
Date 2021-10-09
Name of individual signing W. HAL SHEPHERD
Role Employer/plan sponsor
Date 2021-10-09
Name of individual signing W. HAL SHEPHERD
MARBLE CITY PHARMACY 401K PLAN 2020 260057535 2021-07-27 MARBLE CITY PHARMACY 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 446110
Sponsor’s telephone number 2562454446
Plan sponsor’s address 264 W. FORT WILLIAMS ST., SYLACAUGA, AL, 35150

Signature of
Role Plan administrator
Date 2021-07-27
Name of individual signing JARED JOHNSON
MARBLE CITY PHARMACY 401K PLAN 2019 260057535 2020-10-13 MARBLE CITY PHARMACY 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 446110
Sponsor’s telephone number 2562454446
Plan sponsor’s address 264 W. FORT WILLIAMS ST., SYLACAUGA, AL, 35150

Incorporator

Name Role Address
HOBSON, JAMES E Incorporator No data
JOHNSON, DANNY R Incorporator 264 W FT WILLIAMS STREETSYLACAUGA, AL 35150

Agent

Name Role
HOBSON, JAMES E Agent

Related by officers

HOBSON, JAMES E

Hobson Plaza Pharmacy, Inc. Sylacauga Training and Enhancement Program, Inc., (S.T.E.P.)

JOHNSON, DANNY R

Citizens Coalition for Responsible Waste Disposal West JeffersonChapter, Inc. JJD REAL ESTATE, LLC

Related by address

SYLACAUGA, AL

Academy Van Lines, Inc. Allen Oil Company of Sylacauga, Inc. Arnold Realty and Mortgage Company, Incorporated Bama Office Supply Inc. Brown Brothers, Inc. of Sylacauga, Alabama BIAC, Inc. Central Land Company, Inc. City Tire Company of Sylacauga, Inc. Coosa Valley Insurance Agency of Sylacauga Deupree of Sylacauga, Inc.

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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