| Name: | Mills Pharmacy at Brookwood, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 18 Jun 2008 (16 years ago) |
| Entity Number: | 000-257-682 |
| Register Number: | 000257682 |
| Historical Names: |
Home Town Pharmacy, Inc.
|
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 2400 MTN DRIVE STE 104HOOVER, AL 35226 |
| Registered Office Street Address ZIP Code: | 35226 |
| Registered Office Mailing Address: | PO BOX 26679BIRMINGHAM, AL 35260 |
| Registered Office Mailing Address ZIP Code: | 35260 |
| Authorized Capital: | $100 |
| Paid Share Capital: | $100 |
Activities
PHARMACY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710140710 | 2008-07-09 | 2021-10-13 | PO BOX 26679, BIRMINGHAM, AL, 352600679, US | 16114 HIGHWAY 216 STE A, BROOKWOOD, AL, 354443756, US | |||||||||||||||||||||||||||||||||
|
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| Phone | +1 205-871-9007 |
| Fax | 2058749946 |
| Phone | +1 205-556-1600 |
| Fax | 2055561777 |
Authorized person
| Name | JOSH HARDIN |
| Role | OWNER |
| Phone | 2054270955 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 113118 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 1996314 |
| Issuer | MEDICAID |
| Number | 103087 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| LONG, BEETINA | Agent | 2087 BANEBERRY DRHOOVER, AL 35244 |
| Name | Role | Address |
|---|---|---|
| MILLS, ROBERT | Incorporator | 758 SHADES MOUNTAIN PLAZAHOOVER, AL 35226 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2016-01-15 | Name Change | Home Town Pharmacy, Inc. | Mills Pharmacy at Brookwood, Inc. |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
