0001718392-17-000001.txt : 20171002 0001718392-17-000001.hdr.sgml : 20171002 20171002155136 ACCESSION NUMBER: 0001718392-17-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b ITEM INFORMATION: 4a5 FILED AS OF DATE: 20171002 DATE AS OF CHANGE: 20171002 EFFECTIVENESS DATE: 20171002 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Natural State Medical Group, Inc. CENTRAL INDEX KEY: 0001718392 IRS NUMBER: 822172664 STATE OF INCORPORATION: AR FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-295796 FILM NUMBER: 171114486 BUSINESS ADDRESS: STREET 1: 5201 NORTHSHORE DRIVE CITY: NORTH LITTLE ROCK STATE: AR ZIP: 72118 BUSINESS PHONE: 501-690-2855 MAIL ADDRESS: STREET 1: 5201 NORTHSHORE DRIVE CITY: NORTH LITTLE ROCK STATE: AR ZIP: 72118 D 1 primary_doc.xml X0708 D LIVE 0001718392 Natural State Medical Group, Inc. 5201 NORTHSHORE DRIVE NORTH LITTLE ROCK AR ARKANSAS 72118 501-690-2855 ARKANSAS None None Corporation true 2017 James R Adametz 17 Paradise Lane Little Rock AR ARKANSAS 72223 Executive Officer Director Promoter Zada Virginia Adametz 17 Paradise Lane Little Rock AR ARKANSAS 72223 Director Mary C Caroom 238 SW D Street Bentonville AR ARKANSAS 72712 Executive Officer Director Julia Hart 64 Chenal Circle Little Rock AR ARKANSAS 72223 Director Tommy Ives 1678 South Moore Road Hot Springs AR ARKANSAS 71913 Executive Officer Director Agriculture No Revenues 06b 4a5 false 2017-09-11 false true false 0 None None None None 5201 Northshore Drive North Little Rock AR ARKANSAS 72118 AR ARKANSAS false 4500000 925000 3575000 true 0 7 0 0 0 false Natural State Medical Group, Inc. S Graham Catlett S Graham Catlett Attorney under Power of Attorney 2017-10-02