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Orange Beach Family Pharmacy, L.L.C.

Details

Name: Orange Beach Family Pharmacy, L.L.C.
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Dissolved
Date of registration: 14 Aug 1996 (28 years ago)
Date of dissolution: 19 Aug 2008
Entity Number: 000-654-490
Register Number: 000654490
County: Baldwin
Place of Formation: Baldwin County
Principal Address: 4223 ORANGE BEACH BLVDORANGE BEACH, AL 36561
Principal Address ZIP Code: 36561

Activities OPERATE A PHARMACY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1205830999 2005-06-09 2008-01-04 25299 A CANAL ROAD #6, ORANGE BEACH, AL, 36561, US 25299 A CANAL ROAD #6, ORANGE BEACH, AL, 36561, US

Contacts

Phone +1 251-981-2255
Fax 2519812282

Authorized person

Name PATTISUE CARRANZA
Role PRESIDENT/OWNER
Phone 2519812255

Taxonomy

Taxonomy Code 332B00000X - Durable Medical Equipment & Medical Supplies
License Number 110764
State AL
Is Primary No
Taxonomy Code 333600000X - Pharmacy
License Number 110764
State AL
Is Primary Yes

Agent

Name Role
JUSTICE, W J Agent

Member

Name Role Address
JUSTICE, W J Member No data
COTTRELL, CHARLES D Member 810 EAST CRAIG STREETATMORE, AL 36502
PATRICK, FERREL Member No data
CARRANZA, PATTISUE Member No data

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State