| Name: | PARKS AVENUE DRUGS, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 26 Apr 2016 (9 years ago) |
| Date of dissolution: | 28 Mar 2022 |
| Entity Number: | 000-361-039 |
| Register Number: | 000361039 |
| ZIP code: | 35768 |
| County: | Jackson |
| Place of Formation: | Jackson County |
| Registered Office Street Address: | 410 F. PARKS AVENUESCOTTSBORO, AL 35768 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588062004 | 2014-12-16 | 2014-12-16 | 410 PARKS AVE STE F, SCOTTSBORO, AL, 357682437, US | 410 PARKS AVE STE F, SCOTTSBORO, AL, 357682437, US | |||||||||||||||||||||||||||||||
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| Phone | +1 256-999-0410 |
| Fax | 2569990411 |
Authorized person
| Name | WILLIAM HANEY |
| Role | SUPERVISOR PHARMACIST |
| Phone | 2569990410 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 114439 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PK |
| Number | 2149300 |
| Name | Role | Address |
|---|---|---|
| HOLLAND, SANFORD H | Agent | 416 F. PARKS AVENUESCOTTSBORO, AL 35768 |
| Name | Role | Address |
|---|---|---|
| HOLLAND, SANFORD H | Organizer | 416 F. PARKS AVENUESCOTTSBORO, AL 35768 |
| HANEY, WILLIAM V | Organizer | 410 F. PARKS AVENUESCOTTSBORO, AL 35768 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 8473687006 | 2020-04-08 | 0459 | PPP | 410 PARKS AVE SUITE F, SCOTTSBORO, AL, 35768-2437 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
