0001787834-19-000008.txt : 20191122 0001787834-19-000008.hdr.sgml : 20191122 20191122152507 ACCESSION NUMBER: 0001787834-19-000008 CONFORMED SUBMISSION TYPE: D/A PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20191122 DATE AS OF CHANGE: 20191122 EFFECTIVENESS DATE: 20191122 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/A SEC ACT: 1933 Act SEC FILE NUMBER: 021-335731 FILM NUMBER: 191241094 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 CITY: FRAMINGHAM STATE: MA ZIP: 01701 D/A 1 primary_doc.xml X0708 D/A LIVE 0001691252 I-Pass Patient Safety Institute, Inc. 745 Atlantic Ave., 8th Floor Boston MA MASSACHUSETTS 02111 888-442-3899 DELAWARE None None Corporation true 2016 William Floyd 745 Atlantic Ave., 8th Floor Boston MA MASSACHUSETTS 02111 Executive Officer Director Timothy O'Shea 745 Atlantic Ave., 8th Floor Boston MA MASSACHUSETTS 02111 Executive Officer Director Christopher Landrigan 745 Atlantic Ave., 8th Floor Boston MA MASSACHUSETTS 02111 Director Nancy D. Spector 745 Atlantic Ave., 8th Floor Boston MA MASSACHUSETTS 02111 Director Amy J. Starmer 745 Atlantic Ave., 8th Floor Boston MA MASSACHUSETTS 02111 Director Theodore C Sectish 745 Atlantic Ave., 8th Floor Boston MA MASSACHUSETTS 02111 Director Zachary M. Zeitlin 745 Atlantic Ave., 8th Floor Boston MA MASSACHUSETTS 02111 Director Scott Pitt 745 Atlantic Ave., 8th Floor Boston MA MASSACHUSETTS 02111 Executive Officer Ralph Fargnoli 745 Atlantic Ave., 8th Floor Boston MA MASSACHUSETTS 02111 Director Other Technology Decline to Disclose 06b true 0001080368-19-000011 2019-03-08 false true true false 5000 950000 658000 292000 false 5 0 0 0 false I-Pass Patient Safety Institute, Inc. /Scott Pitt/ Scott Pitt CFO 2019-11-22