0001360647-15-000004.txt : 20150612 0001360647-15-000004.hdr.sgml : 20150612 20150612145733 ACCESSION NUMBER: 0001360647-15-000004 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20150612 DATE AS OF CHANGE: 20150612 EFFECTIVENESS DATE: 20150612 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Greater Michigan Lithotripsy, LLC CENTRAL INDEX KEY: 0001360647 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-241666 FILM NUMBER: 15928220 BUSINESS ADDRESS: STREET 1: 100 W 3RD AVE STREET 2: SUITE 350 CITY: COLUMBUS STATE: OH ZIP: 43201 BUSINESS PHONE: 614-298-8150 MAIL ADDRESS: STREET 1: 100 W 3RD AVE STREET 2: SUITE 350 CITY: COLUMBUS STATE: OH ZIP: 43201 FORMER COMPANY: FORMER CONFORMED NAME: Greater Michigan Lithotripsy LLC DATE OF NAME CHANGE: 20060426 D 1 primary_doc.xml X0707 D LIVE 0001360647 Greater Michigan Lithotripsy, LLC 100 W 3RD AVE SUITE 350 COLUMBUS OH OHIO 43201 614-298-8150 DELAWARE Greater Michigan Lithotripsy LLC Limited Liability Company true Robert Bates, MD 100 W 3rd Ave Suite 350 Columbus OH OHIO 43201 Director Throughout this Form D, note that "Directors" are referred to as "Managers" in this entity. Jim Bour, MD 100 W 3rd Ave Suite 350 Columbus OH OHIO 43201 Executive Officer Director Patrick Hurley, MD 100 W 3rd Ave Suite 350 Columbus OH OHIO 43201 Director Thomas Mertz, MD 100 W 3rd Ave Suite 350 Columbus OH OHIO 43201 Director Donald Moylan, MD 100 W 3rd Ave Columbus OH OHIO 43201 Executive Officer Director Ronald Rubenstein, MD 100 W 3rd Ave Suite 350 Columbus OH OHIO 43201 Director Joseph Salisz, MD 100 W 3rd Ave Suite 350 Columbus OH OHIO 43201 Director Dave Thompson, MD 100 W 3rd Ave Suite 350 Columbus OH OHIO 43201 Director Phil Wise, MD 100 W 3rd Ave Suite 350 Columbus OH OHIO 43201 Director Vicki Hollingsworth 100 W 3rd Ave Suite 350 Columbus OH OHIO 43201 Director Representative of William Beaumont Hospital on the Board. Marc Chircop 100 W 3rd Ave Suite 350 Columbus OH OHIO 43201 Director Representative of Spectrum Health Hospitals on the Board. Alan Buergenthal 100 W 3rd Ave Suite 350 Columbus OH OHIO 43201 Director Representative of American Kidney Stone Management, Ltd. on the Board. Other Health Care Decline to Disclose 06b false true false true false 23275 931000 0 931000 true 0 0 0 0 0 false Greater Michigan Lithotripsy, LLC Alan Buergenthal Alan Buergenthal Director 2015-06-12