0001439789-12-000004.txt : 20121102 0001439789-12-000004.hdr.sgml : 20121102 20121102163459 ACCESSION NUMBER: 0001439789-12-000004 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20121102 DATE AS OF CHANGE: 20121102 EFFECTIVENESS DATE: 20121102 FILER: COMPANY DATA: COMPANY CONFORMED NAME: COVENANT SURGICAL PARTNERS INC CENTRAL INDEX KEY: 0001439789 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-186458 FILM NUMBER: 121177238 BUSINESS ADDRESS: STREET 1: 401 COMMERCE STREET STREET 2: SUITE 740 CITY: NASHVILLE STATE: TN ZIP: 37219 BUSINESS PHONE: 615-345-6902 MAIL ADDRESS: STREET 1: 401 COMMERCE STREET STREET 2: SUITE 740 CITY: NASHVILLE STATE: TN ZIP: 37219 D 1 primary_doc.xml X0706 D LIVE 0001439789 COVENANT SURGICAL PARTNERS INC 401 COMMERCE STREET SUITE 740 NASHVILLE TN TENNESSEE 37219 615-345-6902 DELAWARE None None Corporation true 2008 Michael A. Koban 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Executive Officer Director Marnix E. Heersink 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Executive Officer Director Richard K. Jacques 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Executive Officer Director Morton A. Pierce 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Director Lucius E. Burch III 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Director John F. Jacques 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Director James E. Vann 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Director David A. Holst 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Executive Officer Jack F. King 1200 One Nashville Place 150 4th Avenue North Nashville TN TENNESSEE 37219 Executive Officer Barry D. Wesson 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Executive Officer D. Whitcomb Polley 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Executive Officer Other Health Care $25,000,001 - $100,000,000 06 false 2012-09-30 false true false 591906 1183812 1183812 0 false 2 0 0 0 false COVENANT SURGICAL PARTNERS INC Richard K. Jacques Richard K. Jacques President and Chief Executive Officer 2012-11-02