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SOUTHEASTERN MEDICAL SUPPLY, LLC

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Company Details

Name: SOUTHEASTERN MEDICAL SUPPLY, LLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 15 Feb 2008 (17 years ago)
Organization Date: 15 Feb 2008 (17 years ago)
Last Annual Report: 10 May 2024 (a year ago)
Managed By: Members
Organization Number: 0685680
Industry: Health Services
Number of Employees: Medium (20-99)
ZIP code: 40701
City: Corbin, Keavy, Woodbine
Primary County: Whitley County
Principal Office: 120 N LAUREL AVENUE, CORBIN, KY 40701
Place of Formation: KENTUCKY

Registered Agent

Name Role
BARRY MAHAN Registered Agent

Member

Name Role
Barry Daniel Mahan Member

Organizer

Name Role
GLEN RAY BAKER Organizer

National Provider Identifier

NPI Number:
1477335255
Certification Date:
2023-10-17

Authorized Person:

Name:
SARA MAHAN
Role:
BILLING MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
830506651
Plan Year:
2023
Number Of Participants:
18
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
18
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
18
Sponsors Telephone Number:

Licenses

Department License Number License Type / Line of Authority Status Issue Date Effective Date Inactive Date Expiry Date Address
Department of Professional Licensing 290989 Home Medical Equipment and Services Provider Active 2024-02-28 - - 2026-09-30 411 Richmond Rd, Manchester, KY 40962
Department of Professional Licensing 247953 Home Medical Equipment and Services Provider Active 2019-04-19 - - 2025-09-30 120 S. Hwy 27, Suite 4, Somerset, KY 42503
Department of Professional Licensing 169652 Home Medical Equipment and Services Provider Active 2012-10-25 - - 2026-09-30 120 N Laurel Ave, Corbin, KY 40701

Filings

Name File Date
Annual Report 2024-05-10
Registered Agent name/address change 2023-05-10
Annual Report 2023-05-10
Annual Report 2022-05-18
Annual Report 2021-05-14

USAspending Awards / Financial Assistance

Date:
2020-04-09
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
164700.00
Total Face Value Of Loan:
164700.00

Paycheck Protection Program

Date Approved:
2020-04-09
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
164700
Current Approval Amount:
164700
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
165857.48

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Sources: Kentucky Secretary of State