0001209191-21-046096.txt : 20210709 0001209191-21-046096.hdr.sgml : 20210709 20210709131708 ACCESSION NUMBER: 0001209191-21-046096 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20210709 DATE AS OF CHANGE: 20210709 EFFECTIVENESS DATE: 20210709 FILER: COMPANY DATA: COMPANY CONFORMED NAME: AMERICAN KIDNEY STONE MANAGEMENT LTD CENTRAL INDEX KEY: 0001019404 IRS NUMBER: 311430603 STATE OF INCORPORATION: OH FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-405725 FILM NUMBER: 211082312 BUSINESS ADDRESS: STREET 1: 100 W. 3RD AVENUE, SUITE 350 CITY: COLUMBUS STATE: OH ZIP: 43201 BUSINESS PHONE: 614-298-8150 MAIL ADDRESS: STREET 1: 100 W. 3RD AVENUE, SUITE 350 CITY: COLUMBUS STATE: OH ZIP: 43201 D 1 primary_doc.xml X0708 D LIVE 0001019404 AMERICAN KIDNEY STONE MANAGEMENT LTD 100 W. 3rd Ave Suite 350 Columbus OH OHIO 43201 614-298-8150 OHIO None None Limited Liability Company true Glenn A. Hetu 1700 West Park Drive Suite 410 Westborough MA MASSACHUSETTS 01581 Executive Officer Director "Directors" are referred to "Managers" in this entity. David M. Stewart, M.D. 100 W. 3rd Ave Suite 350 Columbus OH OHIO 43201 Director "Directors" are referred to "Managers" in this entity. David Blechman 2001 Palmer Ave Suite 205 Larchmont NY NEW YORK 10538 Director "Directors" are referred to "Managers" in this entity. Other Health Care Decline to Disclose 06b false 2021-07-01 false true true false 11000 550000 22000 528000 false 1 0 0 0 false American Kidney Stone Management LTD /s/ Glenn A. Hetu Glenn A. Hetu Secretary 2021-07-09