0001630860-16-000005.txt : 20160819 0001630860-16-000005.hdr.sgml : 20160819 20160819125113 ACCESSION NUMBER: 0001630860-16-000005 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20160819 DATE AS OF CHANGE: 20160819 EFFECTIVENESS DATE: 20160819 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Azalea Health Innovations, Inc. CENTRAL INDEX KEY: 0001630860 IRS NUMBER: 260874838 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-269250 FILM NUMBER: 161842605 BUSINESS ADDRESS: STREET 1: 5871 GLENRIDGE DRIVE, NE STREET 2: SUITE 480 CITY: ATLANTA STATE: GA ZIP: 30328 BUSINESS PHONE: 877-777-7686 MAIL ADDRESS: STREET 1: 5871 GLENRIDGE DRIVE, NE STREET 2: SUITE 480 CITY: ATLANTA STATE: GA ZIP: 30328 D 1 primary_doc.xml X0707 D LIVE 0001630860 Azalea Health Innovations, Inc. 5871 GLENRIDGE DRIVE, NE SUITE 480 ATLANTA GA GEORGIA 30328 877-777-7686 DELAWARE None None Corporation true BAHA ZEIDAN 5871 GLENRIDGE DRIVE, NE SUITE 480 ATLANTA GA GEORGIA 30328 Executive Officer Director NISHITA CUMMINGS 1800 AVENUE OF THE STARS 3RD FLOOR LOS ANGELES CA CALIFORNIA 90067 Director JOHN GLUSHIK 102 CITY HALL PLAZA SUITE 200 DURHAM NC NORTH CAROLINA 27701 Director JOHN KING 5871 GLENRIDGE DRIVE, NE SUITE 480 ATLANTA GA GEORGIA 30328 Director DOUGLAS M. SWORDS 107 W. CENTRAL AVENUE VALDOSTA GA GEORGIA 31601 Executive Officer Other Health Care Decline to Disclose 06b false 2016-07-14 false true false 0 10812067 10812067 0 The total offering amount includes convertible promissory notes. false 2 0 595000 0 false Azalea Health Innovations, Inc. /s/Baha Zeidan Baha Zeidan CEO 2016-08-19