0001691252-18-000001.txt : 20180207 0001691252-18-000001.hdr.sgml : 20180207 20180207112751 ACCESSION NUMBER: 0001691252-18-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20180207 DATE AS OF CHANGE: 20180207 EFFECTIVENESS DATE: 20180207 FILER: COMPANY DATA: COMPANY CONFORMED NAME: I-Pass Patient Safety Institute, Inc. CENTRAL INDEX KEY: 0001691252 IRS NUMBER: 812378891 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-305000 FILM NUMBER: 18579858 BUSINESS ADDRESS: STREET 1: 275 GROVE STREET, SUITE 2-400 CITY: NEWTON STATE: MA ZIP: 02466 BUSINESS PHONE: 508-740-5689 MAIL ADDRESS: STREET 1: 161 WORCESTER ROAD STREET 2: SUITE 402 CITY: FRAMINGHAM STATE: MA ZIP: 01701 D 1 primary_doc.xml X0708 D LIVE 0001691252 I-Pass Patient Safety Institute, Inc. 161 Worcester Road, Suite 402 Framingham MA MASSACHUSETTS 01701 508-740-5689 DELAWARE None None Corporation true 2016 William Floyd 161 Worcester Road, Suite 402 Framingham MA MASSACHUSETTS 01701 Executive Officer Director Tim O'Shea 161 Worcester Road, Suite 402 Framingham MA MASSACHUSETTS 01701 Executive Officer Director Ronald Scott Pitt 161 Worcester Road, Suite 402 Framingham MA MASSACHUSETTS 01701 Executive Officer Christopher Landrigan 161 Worcester Road, Suite 402 Framingham MA MASSACHUSETTS 01701 Director Nancy D. Spector 161 Worcester Road, Suite 402 Framingham MA MASSACHUSETTS 01701 Director Amy J. Starmer 161 Worcester Road, Suite 402 Framingham MA MASSACHUSETTS 01701 Director Ted Sectish 161 Worcester Road, Suite 402 Framingham MA MASSACHUSETTS 01701 Director Zachary M. Zeitlin 161 Worcester Road, Suite 402 Framingham MA MASSACHUSETTS 01701 Director Other Health Care Decline to Disclose 06b false 2018-02-05 false true false 10000 850000 74993 775007 false 2 0 0 0 false I-Pass Patient Safety Institute, Inc. Scott Pitt Scott Pitt CFO 2018-02-07