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  5. Deep South Home Medical Equipment, Inc.

Deep South Home Medical Equipment, Inc.

Details

Name: Deep South Home Medical Equipment, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 24 Jan 2003 (22 years ago)
Entity Number: 000-227-124
Register Number: 000227124
ZIP code: 36301
County: Houston
Place of Formation: Houston County
Registered Office Street Address: 2403 CAMPBELLTON HWYDOTHAN, AL 36301
Authorized Capital: 1600 @ $1 PV

Activities SELL/SERVICE HOME MEDICAL EQUIPMENT

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1871569129 2006-02-27 2019-06-18 2233 E MAIN ST, MONTROSE, CO, 814013831, US 229 SUNRISE LANE, MALVERN, AL, 36349, US

Contacts
Phone +1 970-765-0818
Fax 9704978410
Phone +1 334-671-0471

Authorized person
Name RICKY TODD FLOURNEY
Role AUTHORIZED OFFICIAL
Phone 3346719484

Taxonomy
Taxonomy Code 332B00000X - Durable Medical Equipment & Medical Supplies
License Number 065560
State AL
Is Primary Yes
Taxonomy Code 333600000X - Pharmacy
License Number 112249
State AL
Is Primary No

Other Provider Identifiers
Issuer MEDICAID
Number 009918095
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DEEP SOUTH HOME MEDICAL EQUIPMENT 401(K) PLAN 2023 450495549 2024-03-14 DEEP SOUTH HOME MEDICAL EQUIPMENT, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 446190
Sponsor’s telephone number 3346719484
Plan sponsor’s address 229 SUNRISE LANE, SLOCOMB, AL, 36375

Signature of
Role Plan administrator
Date 2024-03-13
Name of individual signing TIMOTHY OTT
Role Employer/plan sponsor
Date 2024-03-13
Name of individual signing TIMOTHY OTT
DEEP SOUTH HOME MEDICAL EQUIPMENT 401(K) PLAN 2022 450495549 2023-03-20 DEEP SOUTH HOME MEDICAL EQUIPMENT, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 446190
Sponsor’s telephone number 3346719484
Plan sponsor’s address 229 SUNRISE LANE, SLOCOMB, AL, 36375

Signature of
Role Plan administrator
Date 2023-03-20
Name of individual signing R. TODD FLOURNOY
DEEP SOUTH HOME MEDICAL EQUIPMENT 401(K) PLAN 2021 450495549 2022-03-15 DEEP SOUTH HOME MEDICAL EQUIPMENT, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 446190
Sponsor’s telephone number 3346719484
Plan sponsor’s address 229 SUNRISE LANE, SLOCOMB, AL, 36375

Signature of
Role Plan administrator
Date 2022-03-14
Name of individual signing R. TODD FLOURNOY
Role Employer/plan sponsor
Date 2022-03-14
Name of individual signing R. TODD FLOURNOY
DEEP SOUTH HOME MEDICAL EQUIPMENT 401(K) PLAN 2020 450495549 2021-02-24 DEEP SOUTH HOME MEDICAL EQUIPMENT, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 446190
Sponsor’s telephone number 3346719484
Plan sponsor’s address 229 SUNRISE LANE, MALVERN, AL, 36349

Signature of
Role Plan administrator
Date 2021-02-24
Name of individual signing RICKY T. FLOURNOY
Role Employer/plan sponsor
Date 2021-02-24
Name of individual signing RICKY T. FLOURNOY
DEEP SOUTH HOME MEDICAL EQUIPMENT 401(K) PLAN 2019 450495549 2020-03-11 DEEP SOUTH HOME MEDICAL EQUIPMENT, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 446190
Sponsor’s telephone number 3346719484
Plan sponsor’s address 229 SUNRISE LANE, MALVERN, AL, 36349

Signature of
Role Plan administrator
Date 2020-03-11
Name of individual signing RICKY T. FLOURNOY
Role Employer/plan sponsor
Date 2020-03-11
Name of individual signing RICKY T. FLOURNOY

Agent

Name Role
OTT, TIMOTHY Agent

Incorporator

Name Role
FLOURNOY, RICKY TODD Incorporator

Events

Event Date Event Type Old Value New Value
2012-11-15 Capital Change $1,200 Authorized --- Paid In 1600 @ $1 PV Authorized undefined Paid In

Related by officers

FLOURNOY, RICKY TODD

Deep South, L.L.C.

Related by address

No related companies by address

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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