| Name: | Respiratory Associates, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 18 Aug 1997 (27 years ago) (Companies founded in August 1997) |
| Entity Number: | 000-189-652 |
| Register Number: | 000189652 |
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Walker County |
| Principal Address: | JASPER, AL |
| Registered Office Street Address: | 2 NORTH JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
| Authorized Capital: | $100 |
Activities
HOME OXYGEN RENTAL/HOME RESPIRATORY EQUIPMENT AT WHOLESALE
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| YX5BMCW3RJ76 | 2024-09-17 | 1330 SUMMITT, JASPER, AL, 35501, 0104, USA | 6414 S 118TH STREET, OMAHA, NE, 68137, USA | |||||||||||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||||||||
| Division Name | RESPIRATORY ASSOCIATES, LLC |
| Division Number | RESPIRATOR |
| Congressional District | 04 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2023-10-03 |
| Initial Registration Date | 2021-10-15 |
| Entity Start Date | 2019-07-01 |
| Fiscal Year End Close Date | Dec 31 |
Service Classifications
| NAICS Codes | 621399 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | BRENDA VANDERPOOL |
| Role | CONTRACTING MANAGER |
| Address | 6414 S 118TH STREET, OMAHA, NE, 68137, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | TERI KLAVINS |
| Role | VP |
| Address | 6414 S 118TH STREET, OMAHA, NE, 68137, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528179173 | 2006-08-31 | 2020-07-17 | 1330 SUMMITT, JASPER, AL, 355010104, US | 1330 SUMMITT, JASPER, AL, 355010104, US | |||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 205-384-1991 |
| Fax | 2053841977 |
Authorized person
| Name | JON NOVAK |
| Role | OWNER/PRESIDENT |
| Phone | 4022814404 |
Taxonomy
| Taxonomy Code | 332BX2000X - Oxygen Equipment & Supplies (DME) |
| License Number | 900200 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 332BX2000X - Oxygen Equipment & Supplies (DME) |
| License Number | 110 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009713320 |
| State | AL |
| Issuer | BLUE CROSS |
| Number | 39553 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 6190 POWERS FERRY RD STE 600ATLANTA, GA 30339 |
| Name | Role | Address |
|---|---|---|
| SULLIVAN, GILBERT M JR | Incorporator | 2100 C ROCKY RIDGE ROADBIRMINGHAM, AL 35216 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
