| Name: | Goodwater Pharmacy, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 29 Jun 2005 (19 years ago) (Companies founded in June 2005) |
| Entity Number: | 000-242-227 |
| Register Number: | 000242227 |
| ZIP code: | 35072 (Companies in Coosa, 35072) |
| County: | Coosa |
| Place of Formation: | Coosa County |
| Principal Address: | GOODWATER, AL |
| Registered Office Street Address: | 1249 SOUTH MAIN STGOODWATER, AL 35072 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $100 |
Activities
PHARMACY/DRUG STORE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154425106 | 2006-09-12 | 2017-01-13 | PO BOX 48, GOODWATER, AL, 350720048, US | 21338 AL HIGHWAY 9, GOODWATER, AL, 350726621, US | |||||||||||||||||||||||||||||||||
|
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| Phone | +1 256-839-6361 |
| Fax | 2568396481 |
Authorized person
| Name | RICHARD COLLINS |
| Role | PRESIDENT |
| Phone | 2568396361 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 112684 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 1995706 |
| Issuer | MEDICAID |
| Number | 100003637 |
| State | AL |
| Name | Role |
|---|---|
| COLLINS, RICHARD BRADFORD | Agent |
| Name | Role |
|---|---|
| COLLINS, RICHARD BRADFORD | Incorporator |
| COLLINS, PATRICIA A | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
