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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 (4 months ago)
Business ID: 1475286
State of Incorporation: MISSISSIPPI

Agent

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

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

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: 01 May 2025

Sources: Company Profile on Mississippi Secretary of State Website