0001454255-15-000001.txt : 20151118 0001454255-15-000001.hdr.sgml : 20151118 20151118105134 ACCESSION NUMBER: 0001454255-15-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 504(b)(1) (not (i), (ii) or (iii)) FILED AS OF DATE: 20151118 DATE AS OF CHANGE: 20151118 EFFECTIVENESS DATE: 20151118 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Channel Islands Surgicenter, L.P. CENTRAL INDEX KEY: 0001454255 IRS NUMBER: 770418197 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-251446 FILM NUMBER: 151239878 BUSINESS ADDRESS: STREET 1: 2300 WANKEL WAY CITY: OXNARD STATE: CA ZIP: 93030 BUSINESS PHONE: 205-970-2610 MAIL ADDRESS: STREET 1: 3000 RIVERCHASE GALLERIA STREET 2: SUITE 500 CITY: BIRMINGHAM STATE: AL ZIP: 35244 FORMER COMPANY: FORMER CONFORMED NAME: CHANNEL ISLANDS SURGICENTER LP DATE OF NAME CHANGE: 20090116 D 1 primary_doc.xml X0707 D LIVE 0001454255 Channel Islands Surgicenter, L.P. 2300 WANKEL WAY OXNARD CA CALIFORNIA 93030 205-970-2610 CALIFORNIA CHANNEL ISLANDS SURGICENTER LP Limited Partnership true N/A N/A NSC Channel Islands, LLC 569 Brookwood Village, Suite 901 Birmingham AL ALABAMA 35209 Executive Officer Director General Partner Andrew Hayek 569 Brookwood Village, Suite 901 Birmingham AL ALABAMA 35209 Executive Officer Joseph Clark 569 Brookwood Village, Suite 901 Birmingham AL ALABAMA 35209 Executive Officer Peter Clermens 569 Brookwood Village, Suite 901 Birmingham AL ALABAMA 35209 Executive Officer Michael Rucker 569 Brookwood Village, Suite 901 Birmingham AL ALABAMA 35209 Executive Officer N/A N/A Northridge Hospital Medical Center 18300 ROSCOE BLVD NORTHRIDGE CA CALIFORNIA 91328 Executive Officer Director Indirect owner of General Partner N/A N/A Surgical Care Affiliates 569 Brookwood Village, Suite 901 Birmingham AL ALABAMA 35209 Executive Officer Director Indirect owner of General Partner Richard Sharff, Jr. 569 Brookwood Village, Suite 901 Birmingham AL ALABAMA 35209 Executive Officer Other Health Care Decline to Disclose 04 false true false true false 0 N/A None SCA Development, LLC None 569 Brookwood Village, Suite 901 Birmingham AL ALABAMA 35209 AL ALABAMA CA CALIFORNIA false 130245 0 130245 false 0 0 0 0 false Channel Islands Surgicenter, L.P. /s/ McCauley Williams McCauley Williams Attorney for the Issuer 2015-11-18