0001692826-19-000001.txt : 20190617 0001692826-19-000001.hdr.sgml : 20190617 20190617154221 ACCESSION NUMBER: 0001692826-19-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20190617 DATE AS OF CHANGE: 20190617 EFFECTIVENESS DATE: 20190617 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Surgery Center at St. Vincent, LLC CENTRAL INDEX KEY: 0001692826 IRS NUMBER: 813129674 STATE OF INCORPORATION: OR FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-342113 FILM NUMBER: 19901352 BUSINESS ADDRESS: STREET 1: 9135 SW BARNES ROAD CITY: PORTLAND STATE: OR ZIP: 97225 BUSINESS PHONE: 205-545-2734 MAIL ADDRESS: STREET 1: 569 BROOKWOOD VILLAGE, SUITE 901 CITY: BIRMINGHAM STATE: AL ZIP: 35209 FORMER COMPANY: FORMER CONFORMED NAME: Portland Surgery Center, LLC DATE OF NAME CHANGE: 20161221 D 1 primary_doc.xml X0708 D LIVE 0001692826 Surgery Center at St. Vincent, LLC 9135 SW BARNES ROAD PORTLAND OR OREGON 97225 205-545-2734 OREGON Portland Surgery Center, LLC Limited Liability Company true 2016 Bill Pethick 569 Brookwood Village, Suite 901 Birmingham AL ALABAMA 35209 Director Thomas Lorish, MD 4400 NE Halsey Street Portland OR OREGON 97213 Director Brad Henry 4400 NE Halsey Street Portland OR OREGON 97213 Director Sarah Boyles, MD 9135 SW Barnes Road Portland OR OREGON 97225 Director Martin Baggenstos, MD 9135 SW Barnes Road Portland OR OREGON 97225 Director Daniel Janoff, MD 9135 SW Barnes Road Portland OR OREGON 97225 Director Peggy Seidler 9135 SW Barnes Road Portland OR OREGON 97225 Executive Officer William Olson 9135 SW Barnes Road Portland OR OREGON 97225 Executive Officer Other Health Care Decline to Disclose 06b false true false true false 40000 SCA Development, LLC 35451 None None 569 Brookwood Village, Suite 901 Birmingham AL ALABAMA 35209 OR OREGON false 40000 0 40000 false 0 2500 true 0 0 false Surgery Center at St. Vincent, LLC Peggy Seidler Peggy Seidler Secretary 2019-06-17