0001375733-17-000003.txt : 20171117 0001375733-17-000003.hdr.sgml : 20171117 20171116182756 ACCESSION NUMBER: 0001375733-17-000003 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20171117 DATE AS OF CHANGE: 20171116 EFFECTIVENESS DATE: 20171117 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: 021-298982 FILM NUMBER: 171209165 BUSINESS ADDRESS: STREET 1: 330 SEVEN SPRINGS WAY CITY: BRENTWOOD STATE: TN ZIP: 37027 BUSINESS PHONE: 615-920-7000 MAIL ADDRESS: STREET 1: 330 SEVEN SPRINGS WAY 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 X0708 D LIVE 0001375733 HAVASU REGIONAL MEDICAL CENTER, LLC 330 SEVEN SPRINGS WAY BRENTWOOD TN TENNESSEE 37027 615-920-7000 DELAWARE HAVASU REGIONAL MEDICAL CENTER LLC Limited Liability Company true Robert N. Klein 330 Seven Springs Way Brentwood TN TENNESSEE 37027 Executive Officer Director Shannon W. Fiser 330 Seven Springs Way Brentwood TN TENNESSEE 37027 Executive Officer Director Michael Patterson 101 Civic Center Lane Lake Havasu City AZ ARIZONA 86403 Director Bradley R. Owens 330 Seven Springs Way Brentwood TN TENNESSEE 37027 Executive Officer Director Terrence Gleason 101 Civic Center Lane Lake Havasu City AZ ARIZONA 86403 Director Bobby Shah 101 Civic Center Lane Lake Havasu City AZ ARIZONA 86403 Director Pareed Aliyar 1840 Mesquite Avenue #G1 Lake Havasu City AZ ARIZONA 86403 Director J. Michael Grooms 330 Seven Springs WAy Brentwood TN TENNESSEE 37027 Executive Officer Mark B. Poppell 330 Seven Springs Way Brentwood TN TENNESSEE 37027 Executive Officer Christopher J. Monte 330 Seven Springs Way Brentwood TN TENNESSEE 37027 Executive Officer Kathy Teague 330 Seven Springs WAy Brentwood TN TENNESSEE 37027 Executive Officer . PHC-Lake Havasu, Inc. 330 Seven Springs Way Brentwood TN TENNESSEE 37027 Promoter . Province Healthcare Company, LLC 330 Seven Springs Way Brentwood TN TENNESSEE 37027 Promoter . LifePoint Health, Inc. 330 Seven Springs Way Brentwood TN TENNESSEE 37027 Promoter Hospitals and Physicians Decline to Disclose 06b false true false true false 13450 The Securities Group, LLC 118148 Chase Neal 4625349 6465 North Quail Hollow Road Memphis TN TENNESSEE 38120 AZ ARIZONA false 2407550 0 2407550 false 0 50000 0 2407550 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/ Kathy Teague Kathy Teague Secretary 2017-11-16