0001630050-16-000005.txt : 20160422 0001630050-16-000005.hdr.sgml : 20160422 20160422140212 ACCESSION NUMBER: 0001630050-16-000005 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20160422 DATE AS OF CHANGE: 20160422 EFFECTIVENESS DATE: 20160422 FILER: COMPANY DATA: COMPANY CONFORMED NAME: 410 Medical Innovation, LLC CENTRAL INDEX KEY: 0001630050 IRS NUMBER: 463389037 STATE OF INCORPORATION: NC FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-261877 FILM NUMBER: 161586293 BUSINESS ADDRESS: STREET 1: 7 FENTON PLACE CITY: CHAPEL HILL STATE: NC ZIP: 27517 BUSINESS PHONE: 9196307305 MAIL ADDRESS: STREET 1: 7 FENTON PLACE CITY: CHAPEL HILL STATE: NC ZIP: 27517 D 1 primary_doc.xml X0707 D LIVE 0001630050 410 Medical Innovation, LLC 201 West Main Street Suite 305 Durham NC NORTH CAROLINA 27701 9192417900 NORTH CAROLINA None None Limited Liability Company true 2013 Mark Piehl 201 West Main Street Suite 305 Durham NC NORTH CAROLINA 27701 Executive Officer Director Lukas Roush 201 West Main Street Suite 305 Durham NC NORTH CAROLINA 27701 Director Mike Liddell 201 West Main Street Suite 305 Durham NC NORTH CAROLINA 27701 Director Galen Robertson 201 West Main Street Suite 305 Durham NC NORTH CAROLINA 27701 Executive Officer Other Decline to Disclose 06b false 2016-04-12 false true true false 0 2000000 928183 1071817 false 9 0 0 0 false 410 Medical Innovation, LLC /s/ Jeffrey Wolfe Jeffrey Wolfe Attorney-in-Fact 2016-04-22