0001675297-17-000001.txt : 20170419 0001675297-17-000001.hdr.sgml : 20170419 20170419155341 ACCESSION NUMBER: 0001675297-17-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 504(b)(1) (not (i), (ii) or (iii)) ITEM INFORMATION: 06b ITEM INFORMATION: 4a5 FILED AS OF DATE: 20170419 DATE AS OF CHANGE: 20170419 EFFECTIVENESS DATE: 20170419 FILER: COMPANY DATA: COMPANY CONFORMED NAME: PriorAuthNow, Inc CENTRAL INDEX KEY: 0001675297 IRS NUMBER: 812335644 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-285149 FILM NUMBER: 17769962 BUSINESS ADDRESS: STREET 1: 200 EAST CAMPUS VIEW BLVD STREET 2: SUITE 200 CITY: COLUMBUS STATE: OH ZIP: 43235 BUSINESS PHONE: 614-300-5850 MAIL ADDRESS: STREET 1: 200 EAST CAMPUS VIEW BLVD STREET 2: SUITE 200 CITY: COLUMBUS STATE: OH ZIP: 43235 D 1 primary_doc.xml X0707 D LIVE 0001675297 PriorAuthNow, Inc 100 EAST CAMPUS VIEW BLVD SUITE 140 COLUMBUS OH OHIO 43235 614-300-5850 DELAWARE None None Corporation true 2016 Joe Anstine 100 EAST CAMPUS VIEW BLVD Suite 140 Columbus OH OHIO 43235 Executive Officer Director Amol Arora 100 EAST CAMPUS VIEW BLVD Suite 140 Columbus OH OHIO 43235 Executive Officer Director von Zychlin Claus 100 East Campus View Blvd Suite 140 Columbus OH OHIO 43235 Director Blackwell Mike 100 East Campus View Blvd Suite 140 Columbus OH OHIO 43235 Executive Officer Other Technology Decline to Disclose 04 06b 4a5 false 2017-04-07 false true true false 50000 Indefinite 1675000 Indefinite false 9 0 0 0 true false PriorAuthNow, Inc /Mark Stansbury/ Mark K Stansbury Corporation Counsel 2017-04-19