| Name: | Tara Pharmacy SE, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 26 Jan 2005 (20 years ago) (Companies founded in January 2005) |
| Entity Number: | 000-609-181 |
| Register Number: | 000609181 |
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Mississippi |
| Principal Address: | 210 E CAPITOL ST STE 2125JACKSON, MS 32907 |
| Principal Mailing Address: | PO BOX 3977JACKSON, MS 32907 |
| Registered Office Mailing Address: | 444 S PERRY STMONTGOMERY, AL 36104-0347 |
| Registered Office Street Address: | 444 S PERRY STMONTGOMERY, AL 36104 |
Activities
PHARMACY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063549368 | 2007-02-27 | 2020-08-22 | 211 SUMMIT PKWY, SUITE 112, HOMEWOOD, AL, 352094751, US | 211 SUMMIT PKWY, SUITE 112, HOMEWOOD, AL, 352094751, US | |||||||||||||||||||||||||
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| Phone | +1 205-916-2267 |
| Fax | 2059160877 |
Authorized person
| Name | MR. NORBERT A BENNETT |
| Role | CEO |
| Phone | 7166624955 |
Taxonomy
| Taxonomy Code | 1835G0303X - Geriatric Pharmacist |
| License Number | 112737 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS OF AL |
| Number | 510 T115 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| GILL, RICHARD H | Agent | 444 SOUTH PERRY STREETMONTGOMERY, AL 36101 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
