| Name: | CHARLES R. SPIVEY, INC. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 30 Jan 2019 (6 years ago) (Companies founded in January 2019) |
| Entity Number: | 000-541-411 |
| Register Number: | 000541411 |
| ZIP code: | 36863 (Companies in Chambers, 36863) |
| County: | Chambers |
| Place of Formation: | Chambers County |
| Principal Address: | 701 N. GILMER AVENUELANETT, AL 36863 |
| Authorized Capital: | 1000@$1.00PV |
Activities
PHARMACY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558376178 | 2006-07-30 | 2023-12-26 | 701 N GILMER AVE, LANETT, AL, 368632081, US | 701 N GILMER AVE, LANETT, AL, 368632081, US | |||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 334-644-3154 |
| Fax | 3346445600 |
Authorized person
| Name | CHARLES RAY SPIVEY |
| Role | PRESIDENT |
| Phone | 3346443154 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 104710 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000135671A |
| State | GA |
| Issuer | PK |
| Number | 1988802 |
| Issuer | MEDICAID |
| Number | 100003681 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| SPIVEY, CHARLES R | Agent | 701 N. GILMER AVENUELANETT, AL 36863 |
| Name | Role | Address |
|---|---|---|
| SPIVEY, CHARLES R | Director | 701 N. GILMER AVENUELANETT, AL 36863 |
| Name | Role | Address |
|---|---|---|
| SPIVEY, CHARLES R | Incorporator | 701 N. GILMER AVENUELANETT, AL 36863 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
