| Name: | Lake Martin Pharmacy, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 27 Sep 2006 (18 years ago) (Companies founded in September 2006) |
| Entity Number: | 000-484-553 |
| Register Number: | 000484553 |
| ZIP code: | 36853 (Companies in Tallapoosa, 36853) |
| County: | Tallapoosa |
| Place of Formation: | Tallapoosa County |
| Registered Office Street Address: | 201 MARIARDEN RDDADEVILLE, AL 36853 |
Activities
PHARMACEUTICAL MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952407215 | 2006-09-15 | 2008-02-22 | 301 MARIARDEN RD, SUITE A, DADEVILLE, AL, 368536254, US | 301 MARIARDEN RD, SUITE A, DADEVILLE, AL, 368536254, US | |||||||||||||||||||
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| Phone | +1 256-825-7822 |
| Fax | 2568270802 |
Authorized person
| Name | DR. LEE RANDAL MCDONALD |
| Role | PHARMACY MANAGER/OWNER |
| Phone | 2568257822 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 112856 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BRUCE, MICHAEL | Organizer | 42 MALCOLM AVENUE SWRAINSVILLE, AL 35986 |
| Name | Role | Address |
|---|---|---|
| BRUCE, MICHAEL D | Member | 500 HOSPITAL DRIVEWETUMPKA, AL 36092 |
| Name | Role | Address |
|---|---|---|
| BRUCE, MICHAEL D | Agent | 500 HOSPITAL DRIVEWETUMPKA, AL 36092 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
