| Name: | Providence Surgery Centers, LLC |
| Jurisdiction: | Alaska |
| Legal type: | Limited Liability Company |
| Status: | Good Standing |
| Date of registration: | 20 Sep 2005 (19 years ago) |
| Entity Number: | 96203 |
| ZIP code: | 99508 |
| County: | Anchorage |
| Place of Formation: | ALASKA |
| Address: | 3831 PIPER ST., SUITE S-110, ANCHORAGE, AK 99508 |
| Mailing Address: | 3831 PIPER STREET SUITE S-110, ANCHORAGE, AK 99508 |
| Supporting healthcare providers fighting with COVID-19: | $1,430,724 |
Line of Business
62 Health Care and Social AssistanceNAICS
621493 FREESTANDING AMBULATORY SURGICAL AND EMERGENCY CENTERS| Name | Role |
|---|---|
| Providence Alaska Medical | Member |
| Douglas Prevost | Member |
| Brad Sparks | Member |
| Jack Sedwick | Member |
| Gregory Schumacher | Member |
| John Lapkass | Member |
| Doug Vermillion | Member |
| Christina Magill | Member |
| DANIEL CEPELA | Member |
| Eugene Sansoni | Member |
| CIK number | Mailing Address | Business Address | Phone | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1350464 | 3831 PIPER STREET, SUITE S-110, ANCHORAGE, AK, 99508 | 3831 PIPER STREET, SUITE S-110, ANCHORAGE, AK, 99508 | 907-339-7800 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Form type | D |
| File number | 021-261588 |
| Filing date | 2016-04-19 |
| File | View File |
Filings since 2015-08-21
| Form type | D/A |
| File number | 021-226713 |
| Filing date | 2015-08-21 |
| File | View File |
Filings since 2014-10-17
| Form type | D |
| File number | 021-226713 |
| Filing date | 2014-10-17 |
| File | View File |
Filings since 2014-04-07
| Form type | D |
| File number | 021-215063 |
| Filing date | 2014-04-07 |
| File | View File |
Filings since 2013-12-05
| Form type | D |
| File number | 021-207502 |
| Filing date | 2013-12-05 |
| File | View File |
Filings since 2011-09-27
| Form type | D |
| File number | 021-166416 |
| Filing date | 2011-09-27 |
| File | View File |
Filings since 2011-01-26
| Form type | D |
| File number | 021-154416 |
| Filing date | 2011-01-26 |
| File | View File |
Filings since 2011-01-26
| Form type | D |
| File number | 021-154415 |
| Filing date | 2011-01-26 |
| File | View File |
Filings since 2006-01-17
| Form type | REGDEX |
| File number | 021-85335 |
| Filing date | 2006-01-17 |
| File | View File |
| Plan Name | Plan Year | EIN/PN | Received | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CREEKSIDE SURGERY CENTER 401(K) PLAN | 2019 | 203567411 | 2020-10-14 | 36 | |||||||||||||||||||||||
|
|||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2020-10-14 |
| Name of individual signing | PLAN SPONSOR |
| License Number | Type | Status | Issue Date | Date of renewal | Expiration date | Description |
|---|---|---|---|---|---|---|
| 940800 | Business License | Active | 2010-03-11 | 2023-11-20 | 2025-12-31 | LOB: 62 - Health Care and Social Assistance, NAICS: 621493 - FREESTANDING AMBULATORY SURGICAL AND EMERGENCY CENTERS |
| License Number | Program | Type | Status | Issue Date | Effective Date | Expiration Date |
|---|---|---|---|---|---|---|
| PHAG53 | Pharmacy | Drug Room | Active | 2012-08-27 | 2024-04-29 | 2026-06-30 |
Date of last update: 24 Jan 2025
Sources: State of Alaska - Department of Commerce, Community, and Economic Development
