0001503249-15-000001.txt : 20150109 0001503249-15-000001.hdr.sgml : 20150109 20150109095050 ACCESSION NUMBER: 0001503249-15-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20150109 DATE AS OF CHANGE: 20150109 EFFECTIVENESS DATE: 20150109 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Piedmont Stone Center PLLC CENTRAL INDEX KEY: 0001331342 IRS NUMBER: 000000000 STATE OF INCORPORATION: NC FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-231809 FILM NUMBER: 15517839 BUSINESS ADDRESS: STREET 1: 3825 FORRESTGATE DRIVE CITY: WINSTON SALEM STATE: NC ZIP: 27103 BUSINESS PHONE: 336-714-2600 MAIL ADDRESS: STREET 1: 3825 FORRESTGATE DRIVE CITY: WINSTON SALEM STATE: NC ZIP: 27103 D 1 primary_doc.xml X0707 D LIVE 0001331342 Piedmont Stone Center PLLC 3825 FORRESTGATE DRIVE WINSTON SALEM NC NORTH CAROLINA 27103 336-714-2600 NORTH CAROLINA None None Limited Liability Company true CHARLES H. HAUSER 3825 FORREST GATE DR WINSTON SALEM NC NORTH CAROLINA 27103 Executive Officer Promoter CHIEF EXECUTIVE OFFICER. R. DEAN CLOWER, MD 3825 FORREST GATE DR WINSTON SALEM NC NORTH CAROLINA 27103 Director RALPH H. DUCKETT, MD 3825 FORREST GATE DR WINSTON SALEM NC NORTH CAROLINA 27103 Director ROBERT BERTRAM, MD 3825 FORREST GATE DR WINSTON SALEM NC NORTH CAROLINA 27103 Director MORRIS FRIEDMAN, MD 3825 FORREST GATE DR WINSTON SALEM NC NORTH CAROLINA 27103 Director JON HUDSON, MD 3825 FORREST GATE DR WINSTON SALEM NC NORTH CAROLINA 27103 Director STEPHEN DAHLSTEDT, MD 3825 FORREST GATE DR WINSTON SALEM NC NORTH CAROLINA 27103 Director TINK JOHNSON, MD 3825 FORREST GATE DR WINSTON SALEM NC NORTH CAROLINA 27103 Director CHARLES MILLER, MD 3825 FORREST GATE DR WINSTON SALEM NC NORTH CAROLINA 27103 Director BRADLEY STONEKING, MD 3825 FORREST GATE DR WINSTON SALEM NC NORTH CAROLINA 27103 Director Other Health Care Decline to Disclose 06b false true true true false N/A 25800 258000 0 258000 false 0 0 0 N/A 0 N/A false Piedmont Stone Center PLLC /s/ Charles H. Hauser CHARLES H. HAUSER CHIEF EXECUTIVE OFFICER 2015-01-09