0001658799-16-000003.txt : 20160825 0001658799-16-000003.hdr.sgml : 20160825 20160825082020 ACCESSION NUMBER: 0001658799-16-000003 CONFORMED SUBMISSION TYPE: D/A PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20160825 DATE AS OF CHANGE: 20160825 EFFECTIVENESS DATE: 20160825 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/A SEC ACT: 1933 Act SEC FILE NUMBER: 021-267391 FILM NUMBER: 161850423 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/A 1 primary_doc.xml X0707 D/A LIVE 0001658799 Rivanna Medical, LLC 107 E. WATER STREET CHARLOTTESVILLE VA VIRGINIA 22902 800-645-7508 VIRGINIA None None Limited Liability Company true Frank William Mauldin, Jr. 104 Burnet Way Charlottesville VA VIRGINIA 22902 Executive Officer Director Timothy R. Ober PO Box 1600 Gordonsville VA VIRGINIA 22942 Director G. Wayne Moore 1550 Colard Lane Lyons CO COLORADO 80540 Director Kevin Owen 1304 Stonegate Ct. Crozet VA VIRGINIA 22932 Director Joel B. Weinstein 9 Barretts Road Hudson MA MASSACHUSETTS 01749 Director Other Health Care Decline to Disclose 06b true 0001658799-16-000002 2016-07-08 false true false 8500 4000000 3001350 998650 false 5 0 0 180000 true false Rivanna Medical, LLC /F. William Mauldin, Jr./ F. William Mauldin, Jr. CEO 2016-08-24