0000897069-18-000658.txt : 20181227 0000897069-18-000658.hdr.sgml : 20181227 20181227164257 ACCESSION NUMBER: 0000897069-18-000658 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20181227 DATE AS OF CHANGE: 20181227 EFFECTIVENESS DATE: 20181227 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Medford Surgery Center, LLC CENTRAL INDEX KEY: 0001762536 IRS NUMBER: 384079196 STATE OF INCORPORATION: MA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-329047 FILM NUMBER: 181255073 BUSINESS ADDRESS: STREET 1: CROWN COLONY PARK STREET 2: 700 CONGRESS STREET CITY: QUINCY STATE: MA ZIP: 02169 BUSINESS PHONE: (800) 258-4674 MAIL ADDRESS: STREET 1: CROWN COLONY PARK STREET 2: 700 CONGRESS STREET CITY: QUINCY STATE: MA ZIP: 02169 D 1 primary_doc.xml X0708 D LIVE 0001762536 Medford Surgery Center, LLC CROWN COLONY PARK 700 CONGRESS STREET QUINCY MA MASSACHUSETTS 02169 (800) 258-4674 MASSACHUSETTS None None Limited Liability Company true 2018 -- Shields ASC, LLC Crown Colony Park 700 Congress Street Quincy MA MASSACHUSETTS 02169 Executive Officer Managing Member Thomas Shields Crown Colony Park 700 Congress Street Quincy MA MASSACHUSETTS 02169 Executive Officer Director Promoter Executive Officer of Manager of Managing Member and Promoter of Issuer. Sarah Modine Crown Colony Park 700 Congress Street Quincy MA MASSACHUSETTS 02169 Promoter Peter Ferrari Crown Colony Park 700 Congress Street Quincy MA MASSACHUSETTS 02169 Director Promoter Other Health Care Decline to Disclose 06b false 2018-12-12 false true false 27000 1350000 1350000 0 false 9 0 0 0 false Medford Surgery Center, LLC Thomas A. Shields Thomas A. Shields Manager of SFE IV, LLC, Manager of the Managing Member 2018-12-27