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FOUNTAIN PULMONARY P.C.

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Company Details

Name: FOUNTAIN PULMONARY P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 23 Jun 2005 (20 years ago)
Entity Number: 3222422
ZIP code: 10314
County: Richmond
Place of Formation: New York
Address: 800 MANOR ROAD, SUITE 3, STATEN ISLAND, NJ, United States, 10314
Principal Address: 800 MANOR ROAD, SUITE 3, STATEN ISLAND, NY, United States, 10314

Contact Details

Phone +1 718-818-1234

Phone +1 347-562-2753

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
FOUNTAIN PULMONARY P.C. DOS Process Agent 800 MANOR ROAD, SUITE 3, STATEN ISLAND, NJ, United States, 10314

Chief Executive Officer

Name Role Address
ADEBAMBO D OLAJITAN M.D. Chief Executive Officer 800 MANOR ROAD, SUITE #3, STATEN ISLAND, NY, United States, 10314

Unique Entity ID

CAGE Code:
72A91
UEI Expiration Date:
2021-04-13

Business Information

Activation Date:
2020-04-13
Initial Registration Date:
2014-01-29

Commercial and government entity program

CAGE number:
72A91
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2024-03-02
CAGE Expiration:
2027-02-09
SAM Expiration:
2023-03-10

Contact Information

POC:
ADEBAMBO OLAJITAN

National Provider Identifier

NPI Number:
1902816051

Authorized Person:

Name:
DR. ADEBAMBO DOLAPO OLAJITAN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207RP1001X - Pulmonary Disease Physician
Is Primary:
Yes

Contacts:

Fax:
3472895100

History

Start date End date Type Value
2007-06-27 2021-06-01 Address 800 MANOR ROAD, SUITE 3, STATEN ISLAND, NY, 10314, USA (Type of address: Service of Process)
2005-06-23 2007-06-27 Address 27 NATALIE COURT, STATEN ISLAND, NY, 10304, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
210601060870 2021-06-01 BIENNIAL STATEMENT 2021-06-01
170601006582 2017-06-01 BIENNIAL STATEMENT 2017-06-01
150601006376 2015-06-01 BIENNIAL STATEMENT 2015-06-01
130705006118 2013-07-05 BIENNIAL STATEMENT 2013-06-01
090528002586 2009-05-28 BIENNIAL STATEMENT 2009-06-01

USAspending Awards / Financial Assistance

Date:
2020-05-07
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:
1900.00
Total Face Value Of Loan:
1900.00

Paycheck Protection Program

Jobs Reported:
1
Initial Approval Amount:
$1,900
Date Approved:
2020-05-07
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$1,900
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$1,922.91
Servicing Lender:
Itria Ventures LLC
Use of Proceeds:
Payroll: $1,900
Jobs Reported:
1
Initial Approval Amount:
$14,710
Date Approved:
2021-01-20
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$14,710
Race:
Black or African American
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$14,763.12
Servicing Lender:
Itria Ventures LLC
Use of Proceeds:
Payroll: $14,705
Utilities: $1

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Date of last update: 29 Mar 2025

Sources: New York Secretary of State