| Name: | Riverwood Pharmacy, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 20 Mar 2013 (12 years ago) |
| Date of dissolution: | 19 Dec 2018 |
| Entity Number: | 000-276-007 |
| Register Number: | 000276007 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Registered Office Street Address: | 100 RICE MINE ROAD SUITE BTUSCALOOSA, AL 35406 |
| Registered Office Street Address ZIP Code: | 35406 |
Activities
OWN AND OPERATE A PHARMACY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396177986 | 2013-08-06 | 2014-12-19 | 100 RICE MINE ROAD, SUITE B, TUSCALOOSA, AL, 35406, US | 100 RICE MINE ROAD, SUITE B, TUSCALOOSA, AL, 35406, US | |||||||||||||||||||||||
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| Phone | +1 205-469-2270 |
| Fax | 2054692269 |
Authorized person
| Name | BILL COCKRELL |
| Role | PHARMACY MANAGER |
| Phone | 2052080012 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 114169 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2141622 |
| Name | Role | Address |
|---|---|---|
| SHAMBLIN, RICHARD W | Agent | 100 RICE MINE ROAD SUITE BTUSCALOOSA, AL 35406 |
| Name | Role | Address |
|---|---|---|
| SHAMBLIN, RICHARD W | Organizer | 100 RICE MINE ROAD SUITE BTUSCALOOSA, AL 35406 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
