| Name: | Susitna Surgery Center, LLC |
| Jurisdiction: | Alaska |
| Legal type: | Limited Liability Company |
| Status: | Good Standing |
| Date of registration: | 29 Jan 2015 (10 years ago) |
| Entity Number: | 10026613 |
| Place of Formation: | DELAWARE |
| Address: | 4000 MERIDIAN BLVD, FRANKLIN, TN 37607 |
Line of Business
62 Health Care and Social AssistanceNAICS
621493 FREESTANDING AMBULATORY SURGICAL AND EMERGENCY CENTERS| Name | Role |
|---|---|
| David Wallace | Manager |
| Susitna ASC Holdings, LLC a Delaware Limited Liability Company | Member |
| Greg O. Lund, M.D. | Member |
| Kelly Maixner, D.M.D. | Member |
| Cassandra Cook, D.O. | Member |
| Aspen Ridge Holdings, LLC | Member |
| Greg Lund, M.D. | Manager |
| Kevin Jensen, D. O. | Manager |
| Terry Bohlke | Manager |
| Dan Houghton | Manager |
| License Number | Type | Status | Issue Date | Date of renewal | Expiration date | Description |
|---|---|---|---|---|---|---|
| 1078879 | Business License | Active | 2018-09-20 | 2024-10-23 | 2026-12-31 | 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 |
|---|---|---|---|---|---|---|
| 142470 | Pharmacy | Drug Room | Active | 2019-01-29 | 2024-05-13 | 2026-06-30 |
Date of last update: 24 Jan 2025
Sources: State of Alaska - Department of Commerce, Community, and Economic Development
