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The Surgery Center of Fairbanks, LLC

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Entity Number 86448D

Status Good Standing

NameThe Surgery Center of Fairbanks, LLC

Date of registration 26 Apr 2004 (20 years ago)

Legal typeLimited Liability Company

Place of FormationALASKA

Address 2310 PEGER ROAD, FAIRBANKS, AK 99709

Address ZIP code 99709

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 Sponsor Total number of participants File

SCOF 401(K) PLAN

2023

320164482

2024-08-15

THE SURGERY CENTER OF FAIRBANKS LLC

45

View Page

Three-digit plan number (PN)001
Effective date of plan2011-03-01
Business code621493
Sponsor’s telephone number9074587263
Plan sponsor’s address2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of

RolePlan administrator
Date2024-08-15
Name of individual signingSHARON A. ANDERSON

SCOF 401(K) PLAN

2022

320164482

2023-05-30

THE SURGERY CENTER OF FAIRBANKS LLC

47

View Page

Three-digit plan number (PN)001
Effective date of plan2011-03-01
Business code621493
Sponsor’s telephone number9074587263
Plan sponsor’s address2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of

RolePlan administrator
Date2023-05-30
Name of individual signingSHARON A. ANDERSON

SCOF 401(K) PLAN

2021

320164482

2022-06-24

THE SURGERY CENTER OF FAIRBANKS LLC

45

View Page

Three-digit plan number (PN)001
Effective date of plan2011-03-01
Business code621493
Sponsor’s telephone number9074587263
Plan sponsor’s address2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of

RolePlan administrator
Date2022-06-24
Name of individual signingSHARON A. ANDERSON

SCOF 401(K) PLAN

2020

320164482

2021-05-28

THE SURGERY CENTER OF FAIRBANKS LLC

40

View Page

Three-digit plan number (PN)001
Effective date of plan2011-03-01
Business code621493
Sponsor’s telephone number9074587263
Plan sponsor’s address2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of

RolePlan administrator
Date2021-05-28
Name of individual signingSHARON A. ANDERSON

SCOF 401(K) PLAN

2019

320164482

2020-07-21

THE SURGERY CENTER OF FAIRBANKS LLC

42

View Page

Three-digit plan number (PN)001
Effective date of plan2011-03-01
Business code621493
Sponsor’s telephone number9074587263
Plan sponsor’s address2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of

RolePlan administrator
Date2020-07-21
Name of individual signingSHARON A. ANDERSON

SCOF 401(K) PLAN

2018

320164482

2019-07-01

THE SURGERY CENTER OF FAIRBANKS LLC

37

View Page

Three-digit plan number (PN)001
Effective date of plan2011-03-01
Business code621493
Sponsor’s telephone number9074587263
Plan sponsor’s address2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of

RolePlan administrator
Date2019-07-01
Name of individual signingSHARON A. ANDERSON

SCOF 401(K) PLAN

2017

320164482

2018-06-20

THE SURGERY CENTER OF FAIRBANKS LLC

36

View Page

Three-digit plan number (PN)001
Effective date of plan2011-03-01
Business code621493
Sponsor’s telephone number9074587263
Plan sponsor’s address2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of

RolePlan administrator
Date2018-06-20
Name of individual signingSHARON A. ANDERSON

SCOF 401(K) PLAN

2016

320164482

2017-06-12

THE SURGERY CENTER OF FAIRBANKS LLC

36

View Page

Three-digit plan number (PN)001
Effective date of plan2011-03-01
Business code621493
Sponsor’s telephone number9074587263
Plan sponsor’s address2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of

RolePlan administrator
Date2017-06-12
Name of individual signingSHARON A. ANDERSON

SCOF 401(K) PLAN

2015

320164482

2016-06-27

THE SURGERY CENTER OF FAIRBANKS LLC

27

View Page

Three-digit plan number (PN)001
Effective date of plan2011-03-01
Business code621493
Sponsor’s telephone number9074587263
Plan sponsor’s address2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of

RolePlan administrator
Date2016-06-27
Name of individual signingSHARON A. ANDERSON

SCOF 401(K) PLAN

2014

320164482

2015-06-08

THE SURGERY CENTER OF FAIRBANKS LLC

28

View Page

Three-digit plan number (PN)001
Effective date of plan2011-03-01
Business code621493
Sponsor’s telephone number9074587263
Plan sponsor’s address2310 PEGER ROAD, SUITE 100, FAIRBANKS, AK, 99709

Signature of

RolePlan administrator
Date2015-06-08
Name of individual signingSHARON A. ANDERSON

Manager

Name Role

MARK WADE

Manager

TIMOTHY TESLOW

Manager

TOM HAMMOND

Manager

SAM KIM

Manager

JIMMY TAMAI

Manager

Member

Name Role

S A PARTNERS, LLC

Member

TESLOW SURGERY, LLC

Member

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

Registered Agent

Name Role

Mark A Wade

Registered Agent

Date of last update: 26 Aug 2024

Sources

Company info