0001589832-14-000001.txt : 20140319 0001589832-14-000001.hdr.sgml : 20140319 20140318204618 ACCESSION NUMBER: 0001589832-14-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06c FILED AS OF DATE: 20140319 DATE AS OF CHANGE: 20140318 EFFECTIVENESS DATE: 20140319 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Physician Portal, LLC CENTRAL INDEX KEY: 0001589832 IRS NUMBER: 463760927 STATE OF INCORPORATION: AZ FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-213862 FILM NUMBER: 14702506 BUSINESS ADDRESS: STREET 1: 1 E. WASHINGTON STREET STREET 2: SUITE 500 CITY: PHOENIX STATE: AZ ZIP: 85004 BUSINESS PHONE: 888-483-2860 MAIL ADDRESS: STREET 1: 1 E. WASHINGTON STREET STREET 2: SUITE 500 CITY: PHOENIX STATE: AZ ZIP: 85004 D 1 primary_doc.xml X0707 D LIVE 0001589832 Physician Portal, LLC 1 E. WASHINGTON STREET SUITE 500 PHOENIX AZ ARIZONA 85004 888-483-2860 ARIZONA None None Limited Liability Company true 2013 James T. O'Mara 1 E. Washington Street Suite 500 Phoenix AZ ARIZONA 85004 Executive Officer Director Manager and Chief Executive Officer Kevin T. O'Mara 1 E. Washington Street Suite 500 Phoenix AZ ARIZONA 85004 Director Manager Robert Shaw 1 E. Washington Street Suite 500 Phoenix AZ ARIZONA 85004 Director Manager Other Technology Decline to Disclose 06c false 2014-03-04 false true false 50000 1250000 20000 1230000 false 1 0 0 0 false Physician Portal, LLC /s/ James T. O'Mara James T. O'Mara CEO 2014-03-18