0001651412-16-000003.txt : 20161109 0001651412-16-000003.hdr.sgml : 20161109 20161109115050 ACCESSION NUMBER: 0001651412-16-000003 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20161109 DATE AS OF CHANGE: 20161109 EFFECTIVENESS DATE: 20161109 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Dublin Surgery Center, LLC CENTRAL INDEX KEY: 0001651412 IRS NUMBER: 272103713 STATE OF INCORPORATION: OH FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-274116 FILM NUMBER: 161983245 BUSINESS ADDRESS: STREET 1: 5005 PARKCENTER AVENUE CITY: DUBLIN STATE: OH ZIP: 43017 BUSINESS PHONE: 614-932-9548 MAIL ADDRESS: STREET 1: 5005 PARKCENTER AVENUE CITY: DUBLIN STATE: OH ZIP: 43017 D 1 primary_doc.xml X0707 D LIVE 0001651412 Dublin Surgery Center, LLC 5005 PARKCENTER AVENUE DUBLIN OH OHIO 43017 614-932-9548 OHIO None None Limited Liability Company true Richard L. Sharff, Jr. 569 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 Executive Officer Tom W.F. De Weerdt 569 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 Executive Officer Phillip R. Prince 569 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 Executive Officer Other Health Care Decline to Disclose 06b false true false true false 35440 SCA Development, LLC 35451 None None 569 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 OH OHIO false 141760 0 141760 false 0 5000 true 0 0 false Dublin Surgery Center, LLC Richard L. Sharff, Jr. Richard L. Sharff, Jr. VP of SCA-Dublin, LLC, Manager 2016-11-09