| Name: | Medical Center Pharmacy, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 06 Jan 2016 (9 years ago) |
| Entity Number: | 000-356-684 |
| Register Number: | 000356684 |
| County: | Colbert |
| Place of Formation: | Colbert County |
| Registered Office Street Address: | 507 NORTH COLUMBIA AVENUESHEFFIELD, AL 35660 |
| Registered Office Street Address ZIP Code: | 35660 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386005247 | 2016-03-18 | 2016-03-18 | 507 N COLUMBIA AVE, SHEFFIELD, AL, 356602935, US | 507 N COLUMBIA AVE, SHEFFIELD, AL, 356602935, US | |||||||||||||||||||||||||||
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| Phone | +1 256-381-4311 |
| Fax | 2563860903 |
Authorized person
| Name | MICHAEL SIGMON |
| Role | OWNER |
| Phone | 4233123191 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 106701 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2158814 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MEDICAL CENTER PHARMACY (VISION PLAN) | 2020 | 631073516 | 2021-10-12 | MEDICAL CENTER PHARMACY | 0 | |||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 472506773 |
| Plan administrator’s name | KENNION & CO, LLC |
| Plan administrator’s address | 2828 OLD 280 COURT, SUITE 110, VESTAVIA, AL, 35243 |
| Administrator’s telephone number | 8669665457 |
Signature of
| Role | Plan administrator |
| Date | 2021-10-09 |
| Name of individual signing | W. HAL SHEPHERD |
| Role | Employer/plan sponsor |
| Date | 2021-10-09 |
| Name of individual signing | W. HAL SHEPHERD |
| Name | Role | Address |
|---|---|---|
| ADAY, KENNETH W JR | Agent | 2102 JACKSON AVEMUSCLE SHOALS, AL 35661 |
| Name | Role | Address |
|---|---|---|
| ADAY, KENNETH | Member | No data |
| SIGMON, MICHAEL | Member | No data |
| OWEN, PHIL | Member | 165 CHESTNUT DR SUITE DMADISON, AL 35758 |
| Name | Role | Address |
|---|---|---|
| ADAY, KENNETH WAYNE JR | Organizer | 2102 JACKSON AVENUEMUSCLE SHOALS, AL 35661 |
| SIGMON, MICHAEL KEITH | Organizer | 1905 BEECHWOOD CTFLORENCE, AL 35630 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
