| Name: | Copeland Pharmaceutical Services, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 21 Dec 2012 (12 years ago) (Companies founded in December 2012) |
| Date of dissolution: | 14 Feb 2017 |
| Entity Number: | 000-271-614 |
| Register Number: | 000271614 |
| ZIP code: | 35674 (Companies in Colbert, 35674) |
| County: | Colbert |
| Place of Formation: | Colbert County |
| Principal Address: | 104 OLD CAPE DRIVETUSCUMBIA, AL 35674 |
Activities
RETAIL PHARMACEUTICAL SALES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154667970 | 2012-12-26 | 2013-05-03 | 104 OLD CAPE DR, TUSCUMBIA, AL, 356745216, US | 14001 HIGHWAY 43, STE 13, RUSSELLVILLE, AL, 356532848, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 256-616-3311 |
| Fax | 2563892992 |
| Phone | +1 256-331-1919 |
| Fax | 2563311960 |
Authorized person
| Name | GRANT COPELAND |
| Role | OWNER |
| Phone | 2566163311 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 114022 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 144805 |
| State | AL |
| Issuer | PK |
| Number | 2138439 |
| Name | Role | Address |
|---|---|---|
| COPELAND, GRANT | Agent | 104 OLD CAPE DRIVETUSCUMBIA, AL 35674 |
| Name | Role | Address |
|---|---|---|
| COPELAND, GRANT | Organizer | 104 OLD CAPE DRIVETUSCUMBIA, AL 35674 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
