| Name: | Eagle Drugs, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 26 Oct 2010 (14 years ago) |
| Date of dissolution: | 02 Oct 2013 |
| Entity Number: | 000-303-321 |
| Register Number: | 000303321 |
| ZIP code: | 36274 |
| County: | Randolph |
| Place of Formation: | Randolph County |
| Principal Address: | ROANOKE, AL |
| Registered Office Street Address: | 3705 HWY 431ROANOKE, AL 36274 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144520446 | 2010-11-02 | 2011-06-23 | PO BOX 607, ROANOKE, AL, 362740607, US | 3705 HWY 431, ROANOKE, AL, 36274, US | |||||||||||||||||||||
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| Phone | +1 334-863-6337 |
Authorized person
| Name | ERIC SMITH |
| Role | MEMBER |
| Phone | 2562764141 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 113460 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 0136843 |
| Name | Role |
|---|---|
| BOLTON, JAY | Agent |
| Name | Role | Address |
|---|---|---|
| SMITH, ERIC | Member | 2500 31ST STREET SWBIRMINGHAM, AL 35221 |
| BOLTON, JAY | Member | No data |
| MATTOX, TAMMY | Member | No data |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
