0001171843-15-005159.txt : 20150915 0001171843-15-005159.hdr.sgml : 20150915 20150915160114 ACCESSION NUMBER: 0001171843-15-005159 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20150915 DATE AS OF CHANGE: 20150915 EFFECTIVENESS DATE: 20150915 FILER: COMPANY DATA: COMPANY CONFORMED NAME: American CareSource Holdings, Inc. CENTRAL INDEX KEY: 0001316645 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 200428568 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-247677 FILM NUMBER: 151107745 BUSINESS ADDRESS: STREET 1: 1170 PEACHTREE STREET, NE STREET 2: SUITE 2350 CITY: ATLANTA STATE: GA ZIP: 30309 BUSINESS PHONE: 972-308-6830 MAIL ADDRESS: STREET 1: 1170 PEACHTREE STREET, NE STREET 2: SUITE 2350 CITY: ATLANTA STATE: GA ZIP: 30309 FORMER COMPANY: FORMER CONFORMED NAME: American Caresource Holdings, Inc. DATE OF NAME CHANGE: 20050615 FORMER COMPANY: FORMER CONFORMED NAME: American Caresouce Holdings, Inc. DATE OF NAME CHANGE: 20050204 D 1 primary_doc.xml X0707 D LIVE 0001316645 American CareSource Holdings, Inc. 1170 PEACHTREE STREET, NE SUITE 2350 ATLANTA GA GEORGIA 30309 404-465-1000 DELAWARE None American Caresource Holdings, Inc. American Caresouce Holdings, Inc. Corporation true John Pappajohn 1170 Peachtree St., NE Suite 2350 Atlanta GA GEORGIA 30309 Executive Officer Director Mark Oman 1170 Peachtree St., NE Suite 2350 Atlanta GA GEORGIA 30309 Director Matthew P. Kinley 1170 Peachtree St., NE Suite 2350 Atlanta GA GEORGIA 30309 Director Edward B. Berger 1170 Peachtree St., NE Suite 2350 Atlanta GA GEORGIA 30309 Director Geoffrey E. Harris 1170 Peachtree St., NE Suite 2350 Atlanta GA GEORGIA 30309 Director Norman B. Winland 1170 Peachtree St., NE Suite 2350 Atlanta GA GEORGIA 30309 Executive Officer Adam S. Winger 1170 Peachtree St., NE Suite 2350 Atlanta GA GEORGIA 30309 Executive Officer James A. Honn 1170 Peachtree St., NE Suite 2350 Atlanta GA GEORGIA 30309 Executive Officer Other Health Care Decline to Disclose 06b false 2015-09-02 false true true false 0 510000 510000 0 Guarantors of the Issuer's indebtedness were issued warrants to purchase an aggregate 300,000 shares of the Issuer's common stock at an exercise price of $1.70 per share, which vested immediately and are exercisable any time until August 12, 2020. false 3 0 0 0 false American CareSource Holdings, Inc. /s/ Adam S. Winger Adam S. Winger Interim CFO, General Counsel and VP of Acquisitions 2015-09-15