| Name: | Caremax Pharmacy of Loudon, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Corporation |
| Status: | Exists |
| Date of registration: | 10 Sep 1996 (28 years ago) (Companies founded in September 1996) |
| Entity Number: | 000-360-953 |
| Register Number: | 000360953 |
| ZIP code: | 36116 (Companies in Montgomery, 36116) |
| County: | Montgomery |
| Place of Formation: | Tennessee |
| Registered Office Street Address: | 5331 PERIMETER PARKWAYMONTGOMERY, AL 36116 |
| Principal Address: | 3218 MORRIS AVEKNOXVILLE, TN 37909 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073938775 | 2014-03-04 | 2023-06-23 | 3033 W PRESIDENT GEORGE BUSH HWY STE 100, PLANO, TX, 750755752, US | 5331 PERIMETER PKWY, MONTGOMERY, AL, 361165125, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 972-588-1000 |
| Fax | 9725881001 |
| Phone | +1 334-220-2282 |
| Fax | 8655250522 |
Authorized person
| Name | ANTHONY MOLLICA |
| Role | CHIEF EXECUTIVE OFFICER |
| Phone | 9725881000 |
Taxonomy
| Taxonomy Code | 251F00000X - Home Infusion Agency |
| Is Primary | No |
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 332BP3500X - Parenteral & Enteral Nutrition Supplies (DME) |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | 114303 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 3336H0001X - Home Infusion Therapy Pharmacy |
| Is Primary | Yes |
| Taxonomy Code | 3336S0011X - Specialty Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BOARD OF PHARMACY |
| Number | 114303 |
| State | AL |
| Issuer | MEDICAID |
| Number | 166064 |
| State | AL |
| Name | Role |
|---|---|
| SHERRILL, RON | Agent |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
