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PARKS AVENUE DRUGS, LLC

Details

Name: PARKS AVENUE DRUGS, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Dissolved
Date of registration: 26 Apr 2016 (9 years ago)
Date of dissolution: 28 Mar 2022
Entity Number: 000-361-039
Register Number: 000361039
County: Jackson
Place of Formation: Jackson County
Registered Office Street Address: 410 F. PARKS AVENUESCOTTSBORO, AL 35768
Registered Office Street Address ZIP Code: 35768

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1588062004 2014-12-16 2014-12-16 410 PARKS AVE STE F, SCOTTSBORO, AL, 357682437, US 410 PARKS AVE STE F, SCOTTSBORO, AL, 357682437, US

Contacts

Phone +1 256-999-0410
Fax 2569990411

Authorized person

Name WILLIAM HANEY
Role SUPERVISOR PHARMACIST
Phone 2569990410

Taxonomy

Taxonomy Code 332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary No
Taxonomy Code 3336C0003X - Community/Retail Pharmacy
License Number 114439
State AL
Is Primary Yes
Taxonomy Code 3336C0004X - Compounding Pharmacy
Is Primary No

Other Provider Identifiers

Issuer PK
Number 2149300

Agent

Name Role Address
HOLLAND, SANFORD H Agent 416 F. PARKS AVENUESCOTTSBORO, AL 35768

Organizer

Name Role Address
HOLLAND, SANFORD H Organizer 416 F. PARKS AVENUESCOTTSBORO, AL 35768
HANEY, WILLIAM V Organizer 410 F. PARKS AVENUESCOTTSBORO, AL 35768

Date of last update: 03 Aug 2024

Sources: Alabama Secretary of State