0001592473-15-000004.txt : 20151105 0001592473-15-000004.hdr.sgml : 20151105 20151105132112 ACCESSION NUMBER: 0001592473-15-000004 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20151105 DATE AS OF CHANGE: 20151105 EFFECTIVENESS DATE: 20151105 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Brookhaven Medical, Inc. CENTRAL INDEX KEY: 0001592473 IRS NUMBER: 900959093 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-250743 FILM NUMBER: 151199785 BUSINESS ADDRESS: STREET 1: 3050 PEACHTREE ROAD, NW CITY: ATLANTA STATE: GA ZIP: 30305 BUSINESS PHONE: 404-205-8282 MAIL ADDRESS: STREET 1: 3050 PEACHTREE ROAD, NW CITY: ATLANTA STATE: GA ZIP: 30305 FORMER COMPANY: FORMER CONFORMED NAME: Brookhaven Medical,Inc DATE OF NAME CHANGE: 20131120 D 1 primary_doc.xml X0707 D LIVE 0001592473 Brookhaven Medical, Inc. 3050 PEACHTREE ROAD, NW Suite 370 ATLANTA GA GEORGIA 30305 404-205-8282 DELAWARE Brookhaven Medical,Inc Corporation true 2013 John D. Feltman 3050 Peachtree Road, NW Suite 370 Atlanta GA GEORGIA 30305 Executive Officer Director Stephen Warner 3050 Peachtree Road, NW Suite 370 Atlanta GA GEORGIA 30305 Director James S. Johnson 3050 Peachtree Road, NW Suite 370 Atlanta GA GEORGIA 30305 Director Allen B. Boswell 3050 Peachtree Road, NW Suite 370 Atlanta GA GEORGIA 30305 Director John Ramey 3050 Peachtree Road, NW Suite 370 Atlanta GA GEORGIA 30305 Director Robert E. Altenbach 3050 Peachtree Road, NW Suite 370 Atlanta GA GEORGIA 30305 Executive Officer S. Ross DeDeyn 3050 Peachtree Road, NW Suite 370 Atlanta GA GEORGIA 30305 Executive Officer Other Health Care No Revenues 06b false true false true false 0 11250000 0 11250000 false 0 900000 true 0 The Issuer may engage broker-dealers to offer and sell the securities, who may be paid commissions up to 8% of the total offering amount. 0 false Brookhaven Medical, Inc. /s/ John D. Feltman John D. Feltman Chairman and Chief Executive Officer 2015-11-03