| Name: | Phillips Drug Company LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 25 Jan 2022 (3 years ago) |
| Entity Number: | 000-963-465 |
| Register Number: | 000963465 |
| County: | Montgomery |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 469 SOUTH MCDONOUGH STREETMONTGOMERY, AL 36104 |
| Registered Office Street Address ZIP Code: | 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043377633 | 2007-01-02 | 2022-08-29 | PO BOX 220, CLAYTON, AL, 360160220, US | 23 COURT SQUARE, CLAYTON, AL, 360160220, US | |||||||||||||||||||||||||
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| Phone | +1 334-775-3442 |
| Fax | 3347757711 |
Authorized person
| Name | WILLIAM PHILLIPS |
| Role | OWNER |
| Phone | 3343547812 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 110738 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 100002824 |
| State | AL |
| Name | Role |
|---|---|
| MEMORY, STUART, H. | Agent |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
