0001630860-16-000006.txt : 20160927 0001630860-16-000006.hdr.sgml : 20160927 20160927112536 ACCESSION NUMBER: 0001630860-16-000006 CONFORMED SUBMISSION TYPE: D/A PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20160927 DATE AS OF CHANGE: 20160927 EFFECTIVENESS DATE: 20160927 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/A SEC ACT: 1933 Act SEC FILE NUMBER: 021-269250 FILM NUMBER: 161903726 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/A 1 primary_doc.xml X0707 D/A 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 true 0001630860-16-000005 2016-07-14 false true false 0 HEALTHIS CAPITAL MARKETS, LLC 115542 VICTOR CULIUC 4985575 1101 SKOKIE BOULEVARD SUITE 240 NORTHBROOK IL ILLINOIS 60062 CA CALIFORNIA NC NORTH CAROLINA false 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 2016-09-27