0001793287-20-000001.txt : 20201109 0001793287-20-000001.hdr.sgml : 20201109 20201109171525 ACCESSION NUMBER: 0001793287-20-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20201109 DATE AS OF CHANGE: 20201109 EFFECTIVENESS DATE: 20201109 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Park Hill Surgery Center, LLC CENTRAL INDEX KEY: 0001793287 IRS NUMBER: 451484375 STATE OF INCORPORATION: TX FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-380110 FILM NUMBER: 201298737 BUSINESS ADDRESS: STREET 1: 3455 LOCKE AVENUE, SUITE 100 CITY: FORT WORTH STATE: TX ZIP: 76107 BUSINESS PHONE: 817-585-1900 MAIL ADDRESS: STREET 1: 3455 LOCKE AVENUE, SUITE 100 CITY: FORT WORTH STATE: TX ZIP: 76107 D 1 primary_doc.xml X0708 D LIVE 0001793287 Park Hill Surgery Center, LLC 3455 LOCKE AVENUE, SUITE 100 FORT WORTH TX TEXAS 76107 817-585-1900 TEXAS None None Limited Liability Company true Scott Seidler 3455 Locke Avenue Suite 100 Fort Worth TX TEXAS 76107 Director Andy Dollahite 3455 Locke Avenue Suite 100 Fort Worth TX TEXAS 76107 Director Jawad Qureshi 3455 Locke Avenue Suite 100 Fort Worth TX TEXAS 76107 Director Michael Boothby 3455 Locke Avenue Suite 100 Fort Worth TX TEXAS 76107 Director John Birbari 3455 Locke Avenue Suite 100 Fort Worth TX TEXAS 76107 Director Lenetra King 3455 Locke Avenue Suite 100 Fort Worth TX TEXAS 76107 Director Jeffrey Canose 3455 Locke Avenue Suite 100 Fort Worth TX TEXAS 76107 Executive Officer Chip Zahn 3455 Locke Avenue Suite 100 Fort Worth TX TEXAS 76107 Executive Officer John Mitchell 3455 Locke Avenue Suite 100 Fort Worth TX TEXAS 76107 Executive Officer Rick McWhorter 3455 Locke Avenue Suite 100 Fort Worth TX TEXAS 76107 Executive Officer Other Health Care Decline to Disclose 06b false 2020-10-29 false true false 0 N/A None SCA Development 35451 567 Brookwood Village Suite 901 Birmingham AL ALABAMA 35209 TX TEXAS false 345420 345420 0 false 1 0 0 89152 All proceeds will be used to redeem units held by our current members; some of our members are also members of the Board of Managers false Park Hill Surgery Center, LLC /s/ Nathan Simpson Nathan Simpson Attorney for Issuer 2020-11-09