0001513562-17-000002.txt : 20170202 0001513562-17-000002.hdr.sgml : 20170202 20170202103243 ACCESSION NUMBER: 0001513562-17-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170202 DATE AS OF CHANGE: 20170202 EFFECTIVENESS DATE: 20170202 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Southwest Lincoln Surgery Center, LLC CENTRAL INDEX KEY: 0001513562 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-279868 FILM NUMBER: 17567128 BUSINESS ADDRESS: STREET 1: 4760 RED BANK EXPRESSWAY STREET 2: SUITE 222 CITY: CINCINNATI STATE: OH ZIP: 45227 BUSINESS PHONE: 513-673-8910 MAIL ADDRESS: STREET 1: 4760 RED BANK EXPRESSWAY STREET 2: SUITE 222 CITY: CINCINNATI STATE: OH ZIP: 45227 D 1 primary_doc.xml X0707 D LIVE 0001513562 Southwest Lincoln Surgery Center, LLC 2222 S. 16th Street Suite 315 Lincoln NE NEBRASKA 68502 9133870510 DELAWARE None None Limited Liability Company true Daniel Tomes 2222 S. 16th Street Suite 315 Lincoln NE NEBRASKA 68502 Executive Officer Director Benjamin Bixnmann 2222 S. 16th Street Suite 315 Lincoln NE NEBRASKA 68502 Executive Officer Director David S Diamant 2222 S. 16th Street Suite 315 Lincoln NE NEBRASKA 68502 Executive Officer Director Dean R Forgey 2222 S. 16th Street Suite 315 Lincoln NE NEBRASKA 68502 Executive Officer Director Benjamin Gelber 2222 S. 16th Street Suite 315 Lincoln NE NEBRASKA 68502 Executive Officer Director Mitchell J Henry 2222 S. 16th Street Suite 315 Lincoln NE NEBRASKA 68502 Executive Officer Director Keith P Hughes 2222 S. 16th Street Suite 315 Lincoln NE NEBRASKA 68502 Executive Officer Director Mario Mota 2222 S. 16th Street Suite 315 Lincoln NE NEBRASKA 68502 Executive Officer Director David Samani 2222 S. 16th Street Suite 315 Lincoln NE NEBRASKA 68502 Executive Officer Director Lee Thurber 2222 S. 16th Street Suite 315 Lincoln NE NEBRASKA 68502 Executive Officer Director Joshua Vest 2222 S. 16th Street Suite 315 Lincoln NE NEBRASKA 68502 Executive Officer Director Daniel R Tasset 11221 Roe Avenue Suite 320 Leawood KS KANSAS 66211 Executive Officer Director Hospitals and Physicians Decline to Disclose 06b false 2016-12-01 false true false 65741 131482 131482 0 false 2 0 0 0 false Southwest Lincoln Surgery Center, LLC Daniel Tomes, M.D. Daniel Tomes, M.D. President 2017-01-16