0001710545-19-000003.txt : 20191202 0001710545-19-000003.hdr.sgml : 20191202 20191202154735 ACCESSION NUMBER: 0001710545-19-000003 CONFORMED SUBMISSION TYPE: D/A PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20191202 DATE AS OF CHANGE: 20191202 EFFECTIVENESS DATE: 20191202 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Medically Home Group, Inc. CENTRAL INDEX KEY: 0001710545 IRS NUMBER: 811022962 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D/A SEC ACT: 1933 Act SEC FILE NUMBER: 021-340225 FILM NUMBER: 191263227 BUSINESS ADDRESS: STREET 1: 133 BROOKLINE AVE. CITY: BOSTON STATE: MA ZIP: 02215 BUSINESS PHONE: 617-585-9600 MAIL ADDRESS: STREET 1: 133 BROOKLINE AVE. CITY: BOSTON STATE: MA ZIP: 02215 D/A 1 primary_doc.xml X0708 D/A LIVE 0001710545 Medically Home Group, Inc. 133 BROOKLINE AVE. BOSTON MA MASSACHUSETTS 02215 617-585-9600 DELAWARE Medically Home, LLC None Corporation true 2016 Richard Rakowski c/o Medically Home Group, Inc. 133 BROOKLINE AVE. BOSTON MA MASSACHUSETTS 02215 Executive Officer Director Promoter Andrew Lipman c/o Medically Home Group, Inc. 133 BROOKLINE AVE. BOSTON MA MASSACHUSETTS 02215 Executive Officer Director Promoter Steve Strongwater c/o Medically Home Group, Inc. 133 BROOKLINE AVE. BOSTON MA MASSACHUSETTS 02215 Director Rami Karjian c/o Medically Home Group, Inc. 133 BROOKLINE AVE. BOSTON MA MASSACHUSETTS 02215 Executive Officer David Lee c/o Medically Home Group, Inc. 133 BROOKLINE AVE. BOSTON MA MASSACHUSETTS 02215 Director Vivek Garipalli c/o Medically Home Group, Inc. 133 BROOKLINE AVE BOSTON MA MASSACHUSETTS 02215 Director Joe Kessler c/o Medically Home Group, Inc. 133 BROOKLINE AVE BOSTON MA MASSACHUSETTS 02215 Executive Officer Sung Poblete c/o Medically Home Group, Inc. 133 BROOKLINE AVE BOSTON MA MASSACHUSETTS 02215 Director Clark C. Otley c/o Medically Home Group, Inc. 133 BROOKLINE AVE BOSTON MA MASSACHUSETTS 02215 Director Other Health Care Decline to Disclose 06b true 0001710545-19-000002 2019-05-10 false true false 0 29839606 22839606 7000000 The amount sold includes outstanding principal and accrued and unpaid interest on outstanding debt which converted. false 21 0 0 0 false Medically Home Group, Inc. /s/ Richard Rakowski Richard Rakowski CEO 2019-12-02