| Name: | Ford City Pharmacy, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 28 Nov 2016 (8 years ago) |
| Entity Number: | 000-377-189 |
| Register Number: | 000377189 |
| County: | Colbert |
| Place of Formation: | Colbert County |
| Principal Address: | 331 CARSON ROADMUSCLE SHOALS, AL 35661 |
| Principal Address ZIP Code: | 35661 |
| Authorized Capital: | 100@$1.00PV |
Activities
CONDUCT ANY BUSINESS ACTIVITIES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508159450 | 2011-05-25 | 2017-02-27 | 14490 COUNTY LINE RD, SUITE B, MUSCLE SHOALS, AL, 35661, US | 14490 COUNTY LINE RD, SUITE B, MUSCLE SHOALS, AL, 356614433, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 256-446-8400 |
| Fax | 2564469656 |
Authorized person
| Name | KIM BLANKINSHIP |
| Role | PRESIDENT |
| Phone | 2564468400 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 113715 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 129588 |
| State | AL |
| Issuer | PK |
| Number | 2129966 |
| Name | Role |
|---|---|
| BLANKINSHIP, KIM E | Agent |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
