0001658799-15-000001.txt : 20151202 0001658799-15-000001.hdr.sgml : 20151202 20151202145607 ACCESSION NUMBER: 0001658799-15-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20151202 DATE AS OF CHANGE: 20151202 EFFECTIVENESS DATE: 20151202 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Rivanna Medical, LLC CENTRAL INDEX KEY: 0001658799 IRS NUMBER: 272617660 STATE OF INCORPORATION: VA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-252258 FILM NUMBER: 151264450 BUSINESS ADDRESS: STREET 1: 107 E. WATER STREET CITY: CHARLOTTESVILLE STATE: VA ZIP: 22902 BUSINESS PHONE: 800-645-7508 MAIL ADDRESS: STREET 1: 107 E. WATER STREET CITY: CHARLOTTESVILLE STATE: VA ZIP: 22902 D 1 primary_doc.xml X0707 D LIVE 0001658799 Rivanna Medical, LLC 107 E. WATER STREET CHARLOTTESVILLE VA VIRGINIA 22902 800-645-7508 VIRGINIA None None Limited Liability Company true John A. Williams 682 Poponessett Road Cotuit MA MASSACHUSETTS 02635 Executive Officer Frank William Mauldin, Jr. 104 Burnet Way Charlottesville VA VIRGINIA 22902 Executive Officer Director Promoter G. Wayne Moore 1550 Colard Lane Lyons CO COLORADO 80540 Director Giorgio Brusa 31 Standish Road Needham MA MASSACHUSETTS 02492 Director Promoter Timothy R. Ober PO Box 1600 17490 James Madison Highway Gordonsville VA VIRGINIA 22942 Director Kevin Owen 1304 Stonegate Court Crozet VA VIRGINIA 22932 Director Promoter Other Health Care Decline to Disclose 06b false 2015-11-20 false true false 0 1500000 200376 1299624 false 3 0 0 175000 true false Rivanna Medical, LLC /F. William Mauldin, Jr./ F. William Mauldin, Jr. Chairman 2015-12-02