0001725335-21-000001.txt : 20211012
0001725335-21-000001.hdr.sgml : 20211012
20211012112210
ACCESSION NUMBER: 0001725335-21-000001
CONFORMED SUBMISSION TYPE: D
PUBLIC DOCUMENT COUNT: 1
ITEM INFORMATION: 06b
FILED AS OF DATE: 20211012
DATE AS OF CHANGE: 20211012
EFFECTIVENESS DATE: 20211012
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: PATIENTPAY, INC.
CENTRAL INDEX KEY: 0001725335
IRS NUMBER: 263353802
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: D
SEC ACT: 1933 Act
SEC FILE NUMBER: 021-416511
FILM NUMBER: 211317745
BUSINESS ADDRESS:
STREET 1: 1005 SLATER ROAD, SUITE 214
CITY: DURHAM
STATE: NC
ZIP: 27703
BUSINESS PHONE: (888) 730-9374
MAIL ADDRESS:
STREET 1: 1005 SLATER ROAD, SUITE 214
CITY: DURHAM
STATE: NC
ZIP: 27703
D
1
primary_doc.xml
X0708
D
LIVE
0001725335
PATIENTPAY, INC.
1005 SLATER ROAD, SUITE 100
DURHAM
NC
NORTH CAROLINA
27703
919-794-8080
DELAWARE
None
None
Corporation
true
Thomas
Furr
1005 Slater Road, Suite 100
Durham
NC
NORTH CAROLINA
27703
Executive Officer
Director
Gerald
L.
Wallace Jr.
1005 Slater Road, Suite 100
Durham
NC
NORTH CAROLINA
27703
Director
Lou
Silverman
1005 Slater Road, Suite 100
Durham
NC
NORTH CAROLINA
27703
Director
E.
Miles
Kilburn
1005 Slater Road, Suite 100
Durham
NC
NORTH CAROLINA
27703
Director
Mark
Tomaino
1005 Slater Road, Suite 100
Durham
NC
NORTH CAROLINA
27703
Director
Other
Not Applicable
- 06b
false
2021-08-20
false
true
false
21060
12172604
12172604
0
false
34
0
0
0
false
PATIENTPAY, INC.
/Thomas Furr/
Thomas Furr
Chief Executive Officer
2021-10-12