| Name: | Huntsville Compounding Pharmacy, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 03 Sep 2003 (21 years ago) |
| Date of dissolution: | 13 Aug 2018 |
| Entity Number: | 000-230-818 |
| Register Number: | 000230818 |
| County: | Madison |
| Place of Formation: | Madison County |
| Principal Address: | HUNTSVILLE, AL |
| Registered Office Street Address: | 2121 WHITESBURG DR STE EHUNTSVILLE, AL 35801 |
| Registered Office Street Address ZIP Code: | 35801 |
| Authorized Capital: | $1,000 |
Activities
OPERATE A PHARMACY FOR COMPOUNDING MEDICINES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194810036 | 2006-10-04 | 2013-02-26 | 2121 WHITESBURG DR SE, STE E, HUNTSVILLE, AL, 358014501, US | 2121 WHITESBURG DR SE, STE E, HUNTSVILLE, AL, 358014501, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 256-425-0123 |
| Fax | 2564250195 |
Authorized person
| Name | JAMES GILLESPIE |
| Role | OWNER |
| Phone | 2564250123 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 112434 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 3336S0011X - Specialty Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 0132287 |
| Issuer | MEDICAID |
| Number | 107937 |
| State | AL |
| Name | Role |
|---|---|
| GILLESPIE, JAMES B | Incorporator |
| Name | Role |
|---|---|
| GILLESPIE, JAMES B | Agent |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
