| Name: | Total Skin & Beauty Pharmacy, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 21 Dec 2010 (14 years ago) |
| Date of dissolution: | 04 Aug 2020 |
| Entity Number: | 000-305-531 |
| Register Number: | 000305531 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | 2100 16TH AVENUE SOUTH SUITE 202BIRMINGHAM, AL 35205 |
| Principal Address ZIP Code: | 35205 |
Activities
RETAIL PHARMACY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104101468 | 2011-10-19 | 2017-03-23 | 1620 W NORTHWEST HWY, SUITE 100, GRAPEVINE, TX, 760513177, US | 2100 16TH AVE S STE 112, BIRMINGHAM, AL, 352055021, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 817-572-0009 |
| Fax | 8177201039 |
| Phone | +1 205-380-6170 |
| Fax | 2053806172 |
Authorized person
| Name | JAMES KRELL |
| Role | OWNER |
| Phone | 2055339112 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 113818 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2132380 |
| Name | Role | Address |
|---|---|---|
| MONHEIT, GARY D | Agent | 2100 16TH AVENUE SOUTH STE 202BIRMINGHAM, AL 35205 |
| Name | Role | Address |
|---|---|---|
| TOTAL SKIN & BEAUTY DERMATOLOGY | Member | 2100 16TH AVENUE SOUTH SUITE 202BIRMINGHAM, AL 35205 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
