| Name: | GLOVER DRUGS JASPER, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 02 Jan 2013 (12 years ago) |
| Entity Number: | 000-272-237 |
| Register Number: | 000272237 |
| County: | Walker |
| Place of Formation: | Walker County |
| Registered Office Street Address: | 408 18TH ST WESTJASPER, AL 35501 |
| Registered Office Street Address ZIP Code: | 35501 |
Activities
OPERATING A PHARMACY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326145574 | 2006-09-20 | 2021-01-28 | 408 18TH ST W, JASPER, AL, 355015346, US | 408 18TH ST W, JASPER, AL, 355015346, US | |||||||||||||||||||||||||
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| Phone | +1 205-387-1481 |
| Fax | 2053878744 |
Authorized person
| Name | WILLIAM BRANDON MYERS |
| Role | OWNER |
| Phone | 2053871481 |
Taxonomy
| Taxonomy Code | 183500000X - Pharmacist |
| License Number | 108630 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 100002015 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| GLOVER, KENNETH S II | Agent | 375 HAYFIELD DRIVEDORA, AL 35062 |
| Name | Role | Address |
|---|---|---|
| GLOVER, KENNETH S II | Organizer | 375 HAYFIELD DRIVEDORA, AL 35062 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
