0001112385-17-000004.txt : 20170420 0001112385-17-000004.hdr.sgml : 20170420 20170419195509 ACCESSION NUMBER: 0001112385-17-000004 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170420 DATE AS OF CHANGE: 20170419 EFFECTIVENESS DATE: 20170420 FILER: COMPANY DATA: COMPANY CONFORMED NAME: LACKAWANNA PHYSICIANS AMBULATORY SURGERY CENTER LLC CENTRAL INDEX KEY: 0001112385 IRS NUMBER: 000000000 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-285180 FILM NUMBER: 17771090 BUSINESS ADDRESS: STREET 1: 231 NORTHERN BLVD STREET 2: CLARK XUMMIT CITY: CLARK SUMMIT STATE: PA ZIP: 18411 BUSINESS PHONE: 205-545-2734 MAIL ADDRESS: STREET 1: 569 BROOKWOOD VILLAGE STREET 2: SUITE 901 CITY: BIRMINGHAM STATE: AL ZIP: 35209 D 1 primary_doc.xml X0707 D LIVE 0001112385 LACKAWANNA PHYSICIANS AMBULATORY SURGERY CENTER LLC 231 NORTHERN BLVD CLARK SUMMIT PA PENNSYLVANIA 18411 205-545-2734 PENNSYLVANIA None None Limited Liability Company true N/A Geisinger-SCA Holdings, LLC 569 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 Executive Officer Director Majority Member Kenneth Holdrer 569 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 Executive Officer President Other Health Care Decline to Disclose 06b false 2017-04-07 false true false 0 N/A None SCA Development, LLC 35451 569 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 PA PENNSYLVANIA false 192000 192000 0 false 1 0 0 0 false LACKAWANNA PHYSICIANS AMBULATORY SURGERY CENTER LLC /s/ McCauley Williams McCauley Williams Attorney for Issuer 2017-04-19