| Name: | Gulf Coast Specialty Pharmacy LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 24 Jul 2014 (10 years ago) |
| Date of dissolution: | 17 Dec 2015 |
| Entity Number: | 000-314-661 |
| Register Number: | 000314661 |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Principal Address: | 27188 BLUE MARLIN DRIVEORANGE BEACH, AL 36561 |
| Principal Address ZIP Code: | 36561 |
Activities
ANY LAWFUL PURPOSE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487063996 | 2014-08-08 | 2014-08-08 | 110-A EAST AZALEA AVE, FOLEY, AL, 36535, US | 110-A EAST AZALEA AVE, FOLEY, AL, 36535, US | |||||||||||||||||||
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| Phone | +1 251-424-1487 |
| Fax | 8006389321 |
Authorized person
| Name | DR. ELIZABETH CATLIN STATON |
| Role | PHARMACIST IN CHARGE |
| Phone | 2514241487 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | 114395 |
| State | AL |
| Is Primary | Yes |
| CAGE number | Status | Type | Established | CAGE Update Date | CAGE Expiration | SAM Expiration | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 77X91 | Active | Non-Manufacturer | 2014-09-18 | 2015-09-08 | No data | No data | |||||||||||||||
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| POC | SHERI HALVORSON |
| Phone | +1 251-923-3013 |
| Fax | +1 800-638-9321 |
| Address | 110 A E AZALEA AVE, FOLEY, BALDWIN, AL, 36535 2540, UNITED STATES |
Ownership of Offeror Information
| Highest Level Owner | Information not Available |
|---|
| Immediate Level Owner | Information not Available |
|---|
| List of Offerors (0) | Information not Available |
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| Name | Role | Address |
|---|---|---|
| ACKER, VICKI | Agent | 27188 BLUE MARLIN DRIVEORANGE BEACH, AL 36561 |
| Name | Role | Address |
|---|---|---|
| ACKER, VICKI | Organizer | 27188 BLUE MARLIN DRIVEORANGE BEACH, AL 36561 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
