0001949180-22-000001.txt : 20221006 0001949180-22-000001.hdr.sgml : 20221006 20221006112923 ACCESSION NUMBER: 0001949180-22-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20221006 DATE AS OF CHANGE: 20221006 EFFECTIVENESS DATE: 20221006 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Surgery Center of Wasilla, LLC CENTRAL INDEX KEY: 0001949180 IRS NUMBER: 455023852 STATE OF INCORPORATION: AK FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-460940 FILM NUMBER: 221297436 BUSINESS ADDRESS: STREET 1: 3190 E. MERIDIAN PARK LOOP STREET 2: SUITE 111 CITY: WASILLA STATE: AK ZIP: 99654 BUSINESS PHONE: 907-631-3578 MAIL ADDRESS: STREET 1: 3190 E. MERIDIAN PARK LOOP STREET 2: SUITE 111 CITY: WASILLA STATE: AK ZIP: 99654 D 1 primary_doc.xml X0708 D LIVE 0001949180 Surgery Center of Wasilla, LLC 3190 E. MERIDIAN PARK LOOP SUITE 111 WASILLA AK ALASKA 99654 907-631-3578 ALASKA None None Limited Liability Company true Nick Taylor 4 Westbrook Corporate Center Suite 900 Westchester IL ILLINOIS 60154 Executive Officer Director J Thomas Grissom, M.D. Surgery Center of Wasilla, LLC 3190 E. Meridian Park Loop, Suite 111 Wasilla AK ALASKA 99654 Director Matt Heilala, M.D. Surgery Center of Wasilla 3190 E. Meridian Park Loop, Suite 111 Wasilla AK ALASKA 99654 Director Adam Ellison, M.D. Surgery Center of Wasilla 3190 E. Meridian Park Loop, Suite 111 Wasilla AK ALASKA 99654 Director Charles Haggerty, M.D. Surgery Center of Wasilla 3190 E. Meridian Park Loop, Suite 111 Wasilla AK ALASKA 99654 Director Other Health Care Decline to Disclose 06b false 2022-05-06 false true false 216650 1129002 1129002 0 false 2 0 0 0 false Surgery Center of Wasilla, LLC /s/ Nick Taylor Nick Taylor Manager 2022-10-04