| Name: | Viking Medical Supply, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 04 Jan 2000 (25 years ago) |
| Entity Number: | 000-207-428 |
| Register Number: | 000207428 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 1201 3RD AVE NBIRMINGHAM, AL 35203 |
| Registered Office Street Address ZIP Code: | 35203 |
| Registered Office Mailing Address: | PO BOX 550309BIRMINGHAM, AL 35255 |
| Registered Office Mailing Address ZIP Code: | 35255 |
| Principal Address: | 1201 3RD AVENUE NBIRMINGHAM, AL 35203 |
| Principal Mailing Address: | PO BOX 550309BIRMINGHAM, AL |
| Authorized Capital: | $1,000 |
Activities
MEDICAL EQUIPMENT/SUPPLIES SALES REPRESENTATIVE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629183314 | 2006-08-20 | 2020-09-02 | PO BOX 550309, BIRMINGHAM, AL, 352550309, US | 1201 3RD AVE N, BIRMINGHAM, AL, 352031628, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 205-631-8915 |
| Fax | 2052786900 |
Authorized person
| Name | MR. LONNIE BLAKE DORCEY |
| Role | OWNER/PRESIDENT |
| Phone | 2056318915 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 312 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 335E00000X - Prosthetic/Orthotic Supplier |
| License Number | 128 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 51093833VIK |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VIKING MEDICAL SUPPLY, INC. 401K PROFIT SHARING PLAN & TRUST | 2016 | 631241098 | 2020-10-08 | VIKING MEDICAL SUPPLY, INC. | 6 | |||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2020-10-08 |
| Name of individual signing | MIKO KULOVITZ |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-01-01 |
| Business code | 446190 |
| Sponsor’s telephone number | 2055661674 |
| Plan sponsor’s address | 5789 CARRINGTON LAKE PARKWAY, TRUSSVILLE, AL, 35173 |
Signature of
| Role | Plan administrator |
| Date | 2016-10-05 |
| Name of individual signing | LONNIE DORCEY |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-01-01 |
| Business code | 446190 |
| Sponsor’s telephone number | 2055661674 |
| Plan sponsor’s address | 5789 CARRINGTON LAKE PARKWAY, TRUSSVILLE, AL, 35173 |
Signature of
| Role | Plan administrator |
| Date | 2016-10-05 |
| Name of individual signing | LONNIE DORCEY |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-01-01 |
| Business code | 446190 |
| Sponsor’s telephone number | 2055661674 |
| Plan sponsor’s address | 5789 CARRINGTON LAKE PARKWAY, TRUSSVILLE, AL, 35173 |
Signature of
| Role | Plan administrator |
| Date | 2016-08-03 |
| Name of individual signing | LONNIE DORCEY |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-01-01 |
| Business code | 446190 |
| Sponsor’s telephone number | 2055661674 |
| Plan sponsor’s address | 2509 5TH AVE SOUTH, BIRMINGHAM, AL, 35233 |
Signature of
| Role | Plan administrator |
| Date | 2013-08-06 |
| Name of individual signing | VIKING MEDICAL SUPPLY INC |
| Name | Role | Address |
|---|---|---|
| DORCEY, LONNIE | Agent | 5789 CARRINGTON LAKE PKWYTRUSSVILLE, AL 35173 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
