0001393584-19-000001.txt : 20191127 0001393584-19-000001.hdr.sgml : 20191127 20191127143104 ACCESSION NUMBER: 0001393584-19-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20191127 DATE AS OF CHANGE: 20191127 EFFECTIVENESS DATE: 20191127 FILER: COMPANY DATA: COMPANY CONFORMED NAME: American Well Corp CENTRAL INDEX KEY: 0001393584 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-354402 FILM NUMBER: 191256734 BUSINESS ADDRESS: STREET 1: 75 STATE STREET STREET 2: 26TH FLOOR CITY: Boston STATE: MA ZIP: 02109 BUSINESS PHONE: 6172053500 MAIL ADDRESS: STREET 1: 75 STATE STREET STREET 2: 26TH FLOOR CITY: Boston STATE: MA ZIP: 02109 D 1 primary_doc.xml X0708 D LIVE 0001393584 American Well Corp 75 STATE STREET 26TH FLOOR Boston MA MASSACHUSETTS 02109 617-204-3544 DELAWARE None None Corporation true IDO SCHOENBERG 75 STATE STREET, 26TH FLOOR C/O AMERICAN WELL CORPORATION BOSTON MA MASSACHUSETTS 02109 Executive Officer Director ROY SCHOENBERG 75 STATE STREET, 26TH FLOOR C/O AMERICAN WELL CORPORATION BOSTON MA MASSACHUSETTS 02109 Executive Officer Director BRADFORD F. GAY 75 STATE STREET, 26TH FLOOR C/O AMERICAN WELL CORPORATION BOSTON MA MASSACHUSETTS 02109 Executive Officer KEITH W. ANDERSON 75 STATE STREET, 26TH FLOOR C/O AMERICAN WELL CORPORATION BOSTON MA MASSACHUSETTS 02109 Executive Officer DEVAL PATRICK 75 STATE STREET, 26TH FLOOR C/O AMERICAN WELL CORPORATION BOSTON MA MASSACHUSETTS 02109 Director BRENDAN O'GRADY 75 STATE STREET, 26TH FLOOR C/O AMERICAN WELL CORPORATION BOSTON MA MASSACHUSETTS 02109 Director PETER SLAVIN 75 STATE STREET, 26TH FLOOR C/O AMERICAN WELL CORPORATION BOSTON MA MASSACHUSETTS 02109 Director STANLEY MORTEN 75 STATE STREET, 26TH FLOOR C/O AMERICAN WELL CORPORATION BOSTON MA MASSACHUSETTS 02109 Director NAZIM CETIN 75 STATE STREET, 26TH FLOOR C/O AMERICAN WELL CORPORATION BOSTON MA MASSACHUSETTS 02109 Director DEREK ROSS 75 STATE STREET, 26TH FLOOR C/O AMERICAN WELL CORPORATION BOSTON MA MASSACHUSETTS 02109 Director TOBY COSGROVE 75 STATE STREET, 26TH FLOOR C/O AMERICAN WELL CORPORATION BOSTON MA MASSACHUSETTS 02109 Director STEVE SCHLEGEL 75 STATE STREET, 26TH FLOOR C/O AMERICAN WELL CORPORATION BOSTON MA MASSACHUSETTS 02109 Director Other Health Care Decline to Disclose 06b false 2019-11-14 false true true SHARES ISSUED AS CONSIDERATION TO FORMER STOCKHOLDERS AND OPTIONHOLDERS OF THE COMPANY ACQUIRED BY THE ISSUER 0 32250000 32250000 0 false 11 0 0 0 false American Well Corp BRADFORD F. GAY BRADFORD F. GAY SR. VP & GENERAL COUNSEL 2019-11-27