| Name: | HUNTSVILLE GI PHARMACY, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 14 Feb 2017 (8 years ago) |
| Entity Number: | 000-383-804 |
| Register Number: | 000383804 |
| ZIP code: | 35801 |
| County: | Madison |
| Place of Formation: | Madison County |
| Registered Office Street Address: | 119 LONGWOOD DRIVEHUNTSVILLE, AL 35801 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1477087054 | 2017-04-20 | 2017-04-20 | 1620 W NORTHWEST HWY, SUITE 100, GRAPEVINE, TX, 760513177, US | 119 LONGWOOD DR SW, SUITE 200A, HUNTSVILLE, AL, 358014522, US | |||||||||||||||||||||||||||||||
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| Phone | +1 817-572-0009 |
| Fax | 8177201039 |
Authorized person
| Name | TAMMIE MISKIMINS |
| Role | SENIOR OPERATIONS MANAGER |
| Phone | 8175720009 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 114706 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 3336S0011X - Specialty Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PK |
| Number | 2168951 |
| Name | Role |
|---|---|
| BROWN, MICHAEL W | Agent |
| Name | Role | Address |
|---|---|---|
| JONES, D ASHLEY | Organizer | 100 WASHINGTON STREET STE 100HUNTSVILLE, AL 35801 |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
