| Name: | MediRest, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 27 Jun 1996 (28 years ago) (Companies founded in June 1996) |
| Entity Number: | 000-180-888 |
| Register Number: | 000180888 |
| ZIP code: | 35242 (Companies in Shelby, 35242) |
| County: | Shelby |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 1174 BERWISK ROADHOOVER, AL 35242 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | -- |
Activities
MEDICAL EQUIPMENT SALES/RENTALS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740287085 | 2005-07-01 | 2018-07-18 | 104 OXMOOR RD STE 134, BIRMINGHAM, AL, 352095937, US | 104 OXMOOR RD STE 134, BIRMINGHAM, AL, 35209, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 205-942-1616 |
| Fax | 2059421008 |
Authorized person
| Name | JAMES D FALLON |
| Role | PRESIDENT |
| Phone | 2059421616 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 128 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 332BC3200X - Customized Equipment (DME) |
| Is Primary | No |
| Taxonomy Code | 332BN1400X - Nursing Facility Supplies (DME) |
| License Number | 128 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 332BP3500X - Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | 128 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 332BX2000X - Oxygen Equipment & Supplies (DME) |
| License Number | 128 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 00033911 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| FALLON, JAMES D | Agent | 1174 BERWICK ROADBIRMINGHAM, AL 35242 |
| Name | Role |
|---|---|
| CONN, LEE | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
