0001976949-23-000002.txt : 20230515 0001976949-23-000002.hdr.sgml : 20230515 20230512195101 ACCESSION NUMBER: 0001976949-23-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20230515 DATE AS OF CHANGE: 20230512 EFFECTIVENESS DATE: 20230515 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Origin Medical Systems, Inc. CENTRAL INDEX KEY: 0001976949 IRS NUMBER: 923013233 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-481651 FILM NUMBER: 23917868 BUSINESS ADDRESS: STREET 1: ONE BROADWAY, 14TH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02142 BUSINESS PHONE: 781-219-7596 MAIL ADDRESS: STREET 1: ONE BROADWAY, 14TH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02142 D 1 primary_doc.xml X0708 D LIVE 0001976949 Origin Medical Systems, Inc. ONE BROADWAY, 14TH FLOOR CAMBRIDGE MA MASSACHUSETTS 02142 781-219-7596 DELAWARE None None Corporation true 2023 Jian Fu Jens Thang One Broadway, 14th Floor Cambridge MA MASSACHUSETTS 02142 Executive Officer Director Promoter Sripad Krishna Devalla One Broadway, 14th Floor Cambridge MA MASSACHUSETTS 02142 Executive Officer Promoter Michael Butler One Broadway, 14th Floor Cambridge MA MASSACHUSETTS 02142 Director Stephen Bruso One Broadway, 14th Floor Cambridge MA MASSACHUSETTS 02142 Director Other Technology Decline to Disclose 06b false 2023-05-05 false true false 0 9160500 2460451 6700049 false 6 0 0 0 false Origin Medical Systems, Inc. Jian Fu Jens Thang Jian Fu Jens Thang Chief Executive Officer 2023-05-12