| Name: | Cloverland Drug, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 05 Mar 1991 (34 years ago) |
| Entity Number: | 000-141-952 |
| Register Number: | 000141952 |
| ZIP code: | 36116 |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Principal Address: | MONTGOMERY, AL |
| Registered Office Street Address: | 7037 TIFTON AVENUEMONTGOMERY, AL 36116 |
| Authorized Capital: | $10,000 |
Activities
DRUG STORES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316026164 | 2006-11-03 | 2015-12-21 | PO BOX 240817, MONTGOMERY, AL, 361240817, US | 105 N MEMORIAL DR, PRATTVILLE, AL, 360673332, US | |||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 334-386-2742 |
| Fax | 3343862745 |
| Phone | +1 334-365-3327 |
| Fax | 3343653316 |
Authorized person
| Name | DAVID SAALWAECHTER |
| Role | PRESIDENT |
| Phone | 3343222927 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | 104085 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336M0002X - Mail Order Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PK |
| Number | 2143927 |
| Issuer | MEDICAID |
| Number | 156110 |
| State | AL |
| Name | Role |
|---|---|
| SAALWAECHTER, DAVID G | Incorporator |
| Name | Role |
|---|---|
| SAALWAECHTER, DAVID G | Agent |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
