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PROLIFE MEDICAL SUPPLY INC.

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Company Details

Name: PROLIFE MEDICAL SUPPLY INC.
Jurisdiction: New York
Legal type: DOMESTIC BUSINESS CORPORATION
Status: Active
Date of registration: 06 Jun 2022 (3 years ago)
Entity Number: 6504942
ZIP code: 11235
County: Kings
Place of Formation: New York
Address: 7A BRIGHTON 1ST RD., BROOKLYN, NY, United States, 11235
Principal Address: 7A BRIGHTON 1ST ROAD, BROOKLYN, NY, United States, 11235

Contact Details

Phone +1 718-567-6700

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Agent

Name Role Address
denis izyaguyev Agent 7a brighton 1st rd., BROOKLYN, NY, 11235

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 7A BRIGHTON 1ST RD., BROOKLYN, NY, United States, 11235

Chief Executive Officer

Name Role Address
DENIS IZYAGUYEV Chief Executive Officer 7A BRIGHTON 1ST ROAD, BROOKLYN, NY, United States, 11235

National Provider Identifier

NPI Number:
1396474409
Certification Date:
2025-03-05

Authorized Person:

Name:
MR. DENIS IZYAGUYEV
Role:
PRESIDENT/OWNER
Phone:

Taxonomy:

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

Contacts:

Licenses

Number Status Type Date End date
2111100-DCA Active Business 2023-02-16 2025-03-15

History

Start date End date Type Value
2024-07-30 2024-07-30 Address 7A BRIGHTON 1ST ROAD, BROOKLYN, NY, 11235, USA (Type of address: Chief Executive Officer)
2024-07-30 2024-07-30 Address 535 OCEAN PKWY, 4D, BROOKLYN, NY, 11218, USA (Type of address: Chief Executive Officer)
2023-04-13 2024-07-30 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2023-04-11 2024-07-30 Address 7a brighton 1st rd., BROOKLYN, NY, 11235, USA (Type of address: Registered Agent)
2023-04-11 2024-07-30 Address 7a brighton 1st rd., 4D, BROOKLYN, NY, 11235, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
240730017452 2024-07-30 BIENNIAL STATEMENT 2024-07-30
230411001814 2023-04-11 CERTIFICATE OF CHANGE BY ENTITY 2023-04-11
220606001816 2022-06-06 CERTIFICATE OF INCORPORATION 2022-06-06

Fine And Fees

Fee Sequence Id Fee type Status Date Amount Description
3600047 RENEWAL INVOICED 2023-02-17 200 Dealer in Products for the Disabled License Renewal
3598604 LICENSE INVOICED 2023-02-15 50 Dealer in Products for the Disabled License Fee

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Date of last update: 21 Mar 2025

Sources: New York Secretary of State