0001140361-15-033489.txt : 20150826 0001140361-15-033489.hdr.sgml : 20150826 20150826143657 ACCESSION NUMBER: 0001140361-15-033489 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20150826 DATE AS OF CHANGE: 20150826 EFFECTIVENESS DATE: 20150826 FILER: COMPANY DATA: COMPANY CONFORMED NAME: AUDUBON AMBULATORY SURGERY CENTER LLC CENTRAL INDEX KEY: 0001076722 IRS NUMBER: 000000000 STATE OF INCORPORATION: CO FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-246486 FILM NUMBER: 151075672 BUSINESS ADDRESS: STREET 1: 3204 N ACADEMY BLVD STREET 2: 200 CITY: COLORADO SPRINGS STATE: CO ZIP: 80917 BUSINESS PHONE: 719-867-7500 MAIL ADDRESS: STREET 1: 3030 N. CIRCLE DRIVE CITY: COLORADO SPRINGS STATE: CO ZIP: 80909 D 1 primary_doc.xml X0707 D LIVE 0001076722 AUDUBON AMBULATORY SURGERY CENTER LLC 3030 N. Circle Drive Colorado Springs CO COLORADO 80909 719-867-7500 COLORADO Audobon Ambulatory Surgery Center, LLC None Limited Liability Company true Jameson C. Smith Penrose Hospital 2222 North Nevada Colorado Springs CO COLORADO 80907 Director Related Person as of the Date of First Sale in this Offering Daniel J. Reeves Penrose Hospital 2222 North Nevada Colorado Springs CO COLORADO 80907 Director Related Person as of the Date of First Sale in this Offering Lonnie R. Kraemer Penrose Hospital 2222 North Nevada Colorado Springs CO COLORADO 80907 Director Related Person as of the Date of First Sale in this Offering Mark D. Hartmann Penrose Hospital 2222 North Nevada Colorado Springs CO COLORADO 80907 Director Related Person as of the Date of First Sale in this Offering Wallace Larson Front Range Orthopaedics 4105 Briargate Parkway #300 Colorado Springs CO COLORADO 80920 Director Related Person as of the Date of First Sale in this Offering Jeffrey A. Moody Pikes Peak Urology 6071 E. Woodmen Rd, Suite 300 Colorado Springs CO COLORADO 80923 Executive Officer Director Related Person as of the Date of First Sale in this Offering Ihor J. Fedorak CSSA 6011 E. Woodmen Ste. 345 Colorado Springs CO COLORADO 80923 Director Related Person as of the Date of First Sale in this Offering Michael J. McCann 6071 E. Woodmen Ste. 340 Colorado Springs CO COLORADO 80923 Director Related Person as of the Date of First Sale in this Offering Hospitals and Physicians Decline to Disclose 06b false 2015-07-31 false true true 0 5278000 5278000 0 false 26 0 0 0 false AUDUBON AMBULATORY SURGERY CENTER LLC /s/ Jeffrey Moody, M.D. Jeffrey Moody, M.D. President 2015-08-26