| Name: | Gardendale Health Mart Pharmacy, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 23 Oct 2015 (9 years ago) |
| Entity Number: | 000-347-766 |
| Register Number: | 000347766 |
| ZIP code: | 35226 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 2400 MTN DRIVE STE 104HOOVER, AL 35226 |
| Registered Office Mailing Address: | PO BOX 26679BIRMINGHAM, AL 35260 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306218367 | 2015-10-29 | 2022-02-22 | PO BOX 26679, BIRMINGHAM, AL, 352600679, US | 439 FIELDSTOWN RD STE 145, GARDENDALE, AL, 350713301, US | |||||||||||||||||||||||
|
|||||||||||||||||||||||||||
| Phone | +1 205-871-9007 |
| Fax | 2058749946 |
| Phone | +1 205-631-8989 |
Authorized person
| Name | JOSH HARDIN |
| Role | OWNER |
| Phone | 2054270955 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 18122 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| LONG, BEETINA | Agent | 2087 BANEBERRY DRHOOVER, AL 35244 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
