| Name: | Lillian Pharmacy, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 31 Jul 2009 (15 years ago) (Companies founded in July 2009) |
| Entity Number: | 000-261-682 |
| Register Number: | 000261682 |
| ZIP code: | 36542 (Companies in Baldwin, 36542) |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Principal Address: | GULF SHORES, AL |
| Registered Office Street Address: | 16914 BRIGADOON TRAILGULF SHORES, AL 36542 |
| Authorized Capital: | $1,000 |
Activities
PHARMACY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992760623 | 2006-04-18 | 2018-02-16 | PO BOX 59, LILLIAN, AL, 365490059, US | 34023 US HIGHWAY 98, LILLIAN, AL, 365494053, US | |||||||||||||||||||||||||||||||
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| Phone | +1 251-962-3777 |
| Fax | 2519623779 |
Authorized person
| Name | MINDY KREHLING NOBLES |
| Role | DELEGATED OFFICIAL |
| Phone | 2519623777 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 100115465 |
| State | AL |
| Issuer | PK |
| Number | 2123099 |
| Name | Role | Address |
|---|---|---|
| DAVIS, STACY L | Incorporator | 12831 6TH STREETLILLIAN, AL 36549 |
| Name | Role | Address |
|---|---|---|
| DAVIS, STACY L | Agent | 12831 6TH STREETLILLIAN, AL 36549 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
