| Name: | Abbeville Pharmacy, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 19 Jul 2010 (14 years ago) (Companies founded in July 2010) |
| Entity Number: | 000-449-631 |
| Register Number: | 000449631 |
| ZIP code: | 36375 (Companies in Geneva, 36375) |
| County: | Geneva |
| Place of Formation: | Geneva County |
| Principal Address: | SLOCOMB, AL |
| Registered Office Street Address: | 141 SOUTH DALTON STSLOCOMB, AL 36375 |
Activities
RETAIL PHARMACY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700183753 | 2011-02-26 | 2020-10-06 | 615 OZARK RD, SUITE B, ABBEVILLE, AL, 363102629, US | 615 OZARK RD, SUITE B, ABBEVILLE, AL, 363102629, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 334-585-0246 |
| Fax | 3345850336 |
Authorized person
| Name | JOE DALTON |
| Role | OWNER |
| Phone | 3345850246 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 113492 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2129040 |
| Issuer | MEDICAID |
| Number | 126466 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| DALTON, JOE A | Member | 141 SIYTG DAKTIB STREETSLOCOMB, AL 36375 |
| Name | Role | Address |
|---|---|---|
| DALTON, JOE A | Agent | 141 SIYTG DAKTIB STREETSLOCOMB, AL 36375 |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
