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KCRx Brookhaven LLC

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Company Details

Name: KCRx Brookhaven LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 06 Feb 2025 (6 months ago)
Business ID: 1475286
State of Incorporation: MISSISSIPPI

Member

Name Role Address
Shoemake Group LLC Member 8193 MARTINSVILLE ROAD, WESSON, MS 39191
Garcia Group LLC Member 8193 MARTINSVILLE ROAD, WESSON, MS 39191

Organizer

Name Role Address
Ed C Crawford Organizer 8193 MARTINSVILLE ROAD, WESSON, MS 39191

Agent

Name Role Address
Edward C Crawford Agent 8193 MARTINSVILLE ROAD, WESSON, MS 39191

National Provider Identifier

NPI Number:
1619782323
Certification Date:
2025-02-05

Authorized Person:

Name:
DR. ABBY GARCIA
Role:
OWNER/PIC
Phone:

Taxonomy:

Selected Taxonomy:
3336C0003X - Community/Retail Pharmacy
Is Primary:
Yes

Contacts:

Filings

Type Status Filed Date Description
Formation Form Filed 2025-02-05 Formation For KCRx Brookhaven LLC

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Date of last update: 21 Jun 2025

Sources: Company Profile on Mississippi Secretary of State Website