| Name: | Whitaker Drugs LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 28 Oct 2016 (8 years ago) |
| Entity Number: | 000-375-275 |
| Register Number: | 000375275 |
| County: | Wilcox |
| Place of Formation: | Wilcox County |
| Registered Office Street Address: | 108 BROAD STREETCAMDEN, AL 36726 |
| Registered Office Street Address ZIP Code: | 36726 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164966859 | 2016-12-14 | 2017-03-08 | 20 CAMDEN BYP, CAMDEN, AL, 367261770, US | 20 CAMDEN BYP, CAMDEN, AL, 367261770, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 334-682-9990 |
| Fax | 3346829991 |
Authorized person
| Name | CHARLES WHITAKER |
| Role | PHARMACIST |
| Phone | 3344561589 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 114682 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PK |
| Number | 2166834 |
| Issuer | MEDICAID |
| Number | 194179 |
| State | AL |
| Name | Role |
|---|---|
| FENDLEY, WILLIAM G | Agent |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
