| Name: | Acadiana Pharmaceutical Medical, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Cancelled |
| Date of registration: | 04 Aug 2004 (20 years ago) |
| Entity Number: | 000-607-071 |
| Register Number: | 000607071 |
| County: | Baldwin |
| Place of Formation: | Louisiana |
| Registered Office Street Address: | 26236 FRANK RDELBERTA, AL 36530 |
| Registered Office Street Address ZIP Code: | 36530 |
| Principal Address: | 314 SCHOOL BOARD DRNEW IBERIA, LA 70560 |
Activities
ANY LAWFUL ACTIVITY FOR WHICH AN LLC MAY BE FORMED
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457348641 | 2005-10-03 | 2020-08-22 | 22203 A HWY 59, ROBERTSDALE, AL, 36567, US | 22203 A HWY 59, ROBERTSDALE, AL, 36567, US | |||||||||||||||||||||||||||
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| Phone | +1 251-945-1540 |
| Fax | 2519451542 |
Authorized person
| Name | ROBERT REYBURN ROBERTS III |
| Role | DIRECTOR OF PHARMACY LLC MEMBER |
| Phone | 2519451540 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | 112604 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | NCPDP |
| Number | 0132833 |
| Name | Role |
|---|---|
| MCSHANE, PHILIP TODD | Agent |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
