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  5. The Surgery Center of Fairbanks, LLC

The Surgery Center of Fairbanks, LLC

Contents

Company Details

Name: The Surgery Center of Fairbanks, LLC
Jurisdiction: Alaska
Legal type: Limited Liability Company
Status: Good Standing
Date of registration: 26 Apr 2004 (21 years ago)
Entity Number: 86448D
ZIP code: 99709
County: Fairbanks North Star
Place of Formation: ALASKA
Address: 2310 PEGER ROAD, FAIRBANKS, AK 99709

Officers

Name Role
MARK WADE Manager
S A PARTNERS, LLC Member
TIMOTHY TESLOW Manager
TESLOW SURGERY, LLC Member
TOM HAMMOND Manager
HAMMOND FAIRBANKS SURGERY CENTER, LLC Member
SAM Y KIM, PC Member
TAMAI DEVELOPMENTS, LLC Member
INTERIOR ALASKA ORTHOPEDIC & SPORTS MEDICINE, INC. Member
NEAL EVERSON Member

Central Index Key

CIK number Mailing Address Business Address Phone
1708794 2310 PEGER ROAD, FAIRBANKS, AK, 99709 2310 PEGER ROAD, FAIRBANKS, AK, 99709 907-479-2663

Filings since 2018-01-16
Form type D
File number 021-303324
Filing date 2018-01-16
File View File

Filings since 2017-06-27
Form type D
File number 021-289519
Filing date 2017-06-27
File View File

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
SCOF 401(K) PLAN 2023 320164482 2024-08-15 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-03-01
Sponsor THE SURGERY CENTER OF FAIRBANKS LLC
Business code 621493
Sponsor’s telephone number 9074587263
Plan sponsor’s address 2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2024-08-15
Name of individual signing SHARON A. ANDERSON
SCOF 401(K) PLAN 2022 320164482 2023-05-30 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-03-01
Sponsor THE SURGERY CENTER OF FAIRBANKS LLC
Business code 621493
Sponsor’s telephone number 9074587263
Plan sponsor’s address 2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2023-05-30
Name of individual signing SHARON A. ANDERSON
SCOF 401(K) PLAN 2021 320164482 2022-06-24 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-03-01
Sponsor THE SURGERY CENTER OF FAIRBANKS LLC
Business code 621493
Sponsor’s telephone number 9074587263
Plan sponsor’s address 2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2022-06-24
Name of individual signing SHARON A. ANDERSON
SCOF 401(K) PLAN 2020 320164482 2021-05-28 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-03-01
Sponsor THE SURGERY CENTER OF FAIRBANKS LLC
Business code 621493
Sponsor’s telephone number 9074587263
Plan sponsor’s address 2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2021-05-28
Name of individual signing SHARON A. ANDERSON
SCOF 401(K) PLAN 2019 320164482 2020-07-21 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-03-01
Sponsor THE SURGERY CENTER OF FAIRBANKS LLC
Business code 621493
Sponsor’s telephone number 9074587263
Plan sponsor’s address 2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2020-07-21
Name of individual signing SHARON A. ANDERSON
SCOF 401(K) PLAN 2018 320164482 2019-07-01 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-03-01
Sponsor THE SURGERY CENTER OF FAIRBANKS LLC
Business code 621493
Sponsor’s telephone number 9074587263
Plan sponsor’s address 2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2019-07-01
Name of individual signing SHARON A. ANDERSON
SCOF 401(K) PLAN 2017 320164482 2018-06-20 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-03-01
Sponsor THE SURGERY CENTER OF FAIRBANKS LLC
Business code 621493
Sponsor’s telephone number 9074587263
Plan sponsor’s address 2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2018-06-20
Name of individual signing SHARON A. ANDERSON
SCOF 401(K) PLAN 2016 320164482 2017-06-12 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-03-01
Sponsor THE SURGERY CENTER OF FAIRBANKS LLC
Business code 621493
Sponsor’s telephone number 9074587263
Plan sponsor’s address 2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2017-06-12
Name of individual signing SHARON A. ANDERSON
SCOF 401(K) PLAN 2015 320164482 2016-06-27 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-03-01
Sponsor THE SURGERY CENTER OF FAIRBANKS LLC
Business code 621493
Sponsor’s telephone number 9074587263
Plan sponsor’s address 2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2016-06-27
Name of individual signing SHARON A. ANDERSON
SCOF 401(K) PLAN 2014 320164482 2015-06-08 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-03-01
Sponsor THE SURGERY CENTER OF FAIRBANKS LLC
Business code 621493
Sponsor’s telephone number 9074587263
Plan sponsor’s address 2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2015-06-08
Name of individual signing SHARON A. ANDERSON

Licenses

Type License Number Status Date of issue Date of renewal Expiration date Description
Drug Room PHAG50 Active 2010-11-04 - 2026-06-30 -

Date of last update: 11 Jan 2025

Sources: State of Alaska - Department of Commerce, Community, and Economic Development

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