| Name: | Smiths Station Pharmacy LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 26 Feb 2015 (10 years ago) (Companies founded in February 2015) |
| Entity Number: | 000-329-694 |
| Register Number: | 000329694 |
| ZIP code: | 36303 (Companies in Houston, 36303) |
| County: | Houston |
| Place of Formation: | Lee County |
| Registered Office Street Address: | 212 W. TROY ST. STE BDOTHAN, AL 36303 |
Activities
PHARMACY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750765137 | 2015-07-15 | 2022-01-24 | 2828 LEE ROAD 430, SMITHS STATION, AL, 368772571, US | 2828 LEE ROAD 430, SMITHS STATION, AL, 368772571, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 334-408-6106 |
| Fax | 3344086108 |
Authorized person
| Name | AMIE FLOURNOY |
| Role | OWNER/PIC/AO |
| Phone | 7065736106 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 114499 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2153484 |
| Issuer | MEDICAID |
| Number | 179255 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| REGISTERED AGENTS INC | Agent | 212 W. TROY ST. STE BDOTHAN, AL 36303 |
| Name | Role | Address |
|---|---|---|
| SAFCO MGMT HOLDINGS, LLC | Member | 30 N GOULD ST STE RSHERIDAN, WY 82801 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
