| Name: | Scottsboro Family Pharmacy, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 03 Nov 2004 (20 years ago) (Companies founded in November 2004) |
| Entity Number: | 000-456-866 |
| Register Number: | 000456866 |
| ZIP code: | 35768 (Companies in Jackson, 35768) |
| County: | Jackson |
| Place of Formation: | DeKalb County |
| Principal Address: | SCOTTSBORO, AL |
| Registered Office Street Address: | 102 VETERANS DRSCOTTSBORO, AL 35768 |
Activities
OPERATE A PHARMACY/DRUG STORE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356439780 | 2006-10-11 | 2022-01-27 | 201 VETERANS DR, SUITE 101, SCOTTSBORO, AL, 357682167, US | 201 VETERANS DR, SUITE 101, SCOTTSBORO, AL, 357682167, US | |||||||||||||||||||||||||||||
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| Phone | +1 256-259-9300 |
| Fax | 2562599301 |
Authorized person
| Name | DR. JEFFREY LEE HILL |
| Role | OWNER |
| Phone | 2562599300 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 112614 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 100003588 |
| State | AL |
| Name | Role |
|---|---|
| CARROLL, JOEL K | Agent |
| Name | Role | Address |
|---|---|---|
| CARROLL, JOEL K | Member | No data |
| HILL, JEFFREY | Member | 3024 LARKSPUR LANEHELENA, AL 35022 |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
