| Name: | Killen Pharmacy, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 09 Sep 2008 (16 years ago) |
| Date of dissolution: | 05 Jan 2010 |
| Entity Number: | 000-258-591 |
| Register Number: | 000258591 |
| County: | Lauderdale |
| Place of Formation: | Lauderdale County |
| Principal Address: | LEXINGTON, AL |
| Registered Office Street Address: | 11601 HWY 101LEXINGTON, AL 35648 |
| Registered Office Street Address ZIP Code: | 35648 |
| Authorized Capital: | $100 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912912528 | 2006-07-30 | 2008-10-22 | PO BOX 1285, KILLEN, AL, 356451285, US | 1161 HIGHWAY 72, KILLEN, AL, 356459101, US | |||||||||||||||||||||||
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| Phone | +1 256-757-1161 |
| Fax | 2567571132 |
Authorized person
| Name | KIM BLANKINSHIP |
| Role | PRESIDENT |
| Phone | 2562295550 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 112748 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 0133570 |
| Name | Role |
|---|---|
| BLANKINSHIP, KIM EDWARD | Agent |
| Name | Role |
|---|---|
| BLANKINSHIP, KIM EDWARD | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
