0001707887-19-000002.txt : 20191003 0001707887-19-000002.hdr.sgml : 20191003 20191003151235 ACCESSION NUMBER: 0001707887-19-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20191003 DATE AS OF CHANGE: 20191003 EFFECTIVENESS DATE: 20191003 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Derry Surgical Center, LLC CENTRAL INDEX KEY: 0001707887 IRS NUMBER: 821436601 STATE OF INCORPORATION: NH FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-350297 FILM NUMBER: 191135357 BUSINESS ADDRESS: STREET 1: 11 TSIENNETO ROAD CITY: DERRY STATE: NH ZIP: 03038 BUSINESS PHONE: 205-545-2734 MAIL ADDRESS: STREET 1: 11 TSIENNETO ROAD CITY: DERRY STATE: NH ZIP: 03038 D 1 primary_doc.xml X0708 D LIVE 0001707887 Derry Surgical Center, LLC 11 TSIENNETO ROAD DERRY NH NEW HAMPSHIRE 03038 205-545-2734 NEW HAMPSHIRE None None Limited Liability Company true 2017 Eric Swenson 569 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 Executive Officer Director Tom Buchanon 569 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 Director Gina Mondo 569 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 Director Knut Roalsvig 11 Tsienneto Road Derry NH NEW HAMPSHIRE 03038 Director Fletcher Wilson 11 Tsienneto Road Derry NH NEW HAMPSHIRE 03038 Director Other Health Care Decline to Disclose 06b false true false true false 0 SCA Development, LLC 35451 None None 569 Brookwood Village, Suite 901 Birmingham AL ALABAMA 35209 NH NEW HAMPSHIRE false 225000 0 225000 false 0 25000 true 0 0 false Derry Surgical Center, LLC Eric Swenson Eric Swenson President 2019-10-03