0001375733-12-000001.txt : 20120501 0001375733-12-000001.hdr.sgml : 20120501 20120501163020 ACCESSION NUMBER: 0001375733-12-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20120501 DATE AS OF CHANGE: 20120501 EFFECTIVENESS DATE: 20120501 FILER: COMPANY DATA: COMPANY CONFORMED NAME: HAVASU REGIONAL MEDICAL CENTER, LLC CENTRAL INDEX KEY: 0001375733 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-177532 FILM NUMBER: 12801098 BUSINESS ADDRESS: STREET 1: 103 POWELL COURT SUITE 200 CITY: BRENTWOOD STATE: TN ZIP: 37027 BUSINESS PHONE: 615-372-8500 MAIL ADDRESS: STREET 1: 103 POWELL COURT SUITE 200 CITY: BRENTWOOD STATE: TN ZIP: 37027 FORMER COMPANY: FORMER CONFORMED NAME: HAVASU REGIONAL MEDICAL CENTER LLC DATE OF NAME CHANGE: 20060918 D 1 primary_doc.xml X0705 D LIVE 0001375733 HAVASU REGIONAL MEDICAL CENTER, LLC 103 POWELL COURT BRENTWOOD TN TENNESSEE 37027 615-372-8500 DELAWARE HAVASU REGIONAL MEDICAL CENTER LLC Limited Liability Company true Donald J. Bivacca 103 Powell Court Brentwood TN TENNESSEE 37027 Executive Officer Director John Kerndl 103 Powell Court Brentwood TN TENNESSEE 37027 Executive Officer Director Sandy Podley 101 Civic Center Lane Lake Havasu City AZ ARIZONA 86403 Director Jonathan C. Wall 103 Powell Court Brentwood TN TENNESSEE 37027 Director William Binder 101 Civic Center Lane Lake Havasu City AZ ARIZONA 86403 Director Thomas R. Wrona 101 Civic Center Lane Lake Havasu City AZ ARIZONA 86403 Director Glenn Nudelman 101 Civic Center Lane Lake Havasu City AZ ARIZONA 86403 Director R. Scott Raplee 103 Powell Court Brentwood TN TENNESSEE 37027 Executive Officer Michael S. Coggin 103 Powell Court Brentwood TN TENNESSEE 37027 Executive Officer Mark B. Poppell 103 Powell Court Brentwood TN TENNESSEE 37027 Executive Officer Christopher J. Monte 103 Powell Court Brentwood TN TENNESSEE 37027 Executive Officer Christy S. Green 103 Powell Court Brentwood TN TENNESSEE 37027 Executive Officer . PHC-Lake Havasu, Inc. 103 Powell Court Brentwood TN TENNESSEE 37027 Promoter . Province Healthcare Company 103 Powell Court Brentwood TN TENNESSEE 37027 Promoter . LifePoint Hospitals, Inc. 103 Powell Court Brentwood TN TENNESSEE 37027 Promoter Hospitals and Physicians Decline to Disclose 06 false true false true false 12000 The Securities Group, LLC 118148 Chase Neal 4625349 6465 North Quail Hollow Road Memphis TN TENNESSEE 38120 AZ ARIZONA false 1632000 0 1632000 false 0 45000 0 1632000 true Proceeds from the sale of Class A units in this offering will be used to redeem units in the Issuer from PHC-Lake Havasu, LLC. false HAVASU REGIONAL MEDICAL CENTER, LLC /s/ Donald J. Bivacca Donald J. Bivacca President 2012-05-01