| Name: | Hiawatha Surgery Center LLC |
| Jurisdiction: | Minnesota |
| Legal type: | Limited Liability Company (Domestic) |
| Status: | Inactive |
| Date formed: | 02 Aug 2011 (13 years ago) |
| Company Number: | 478a6bea-97d4-e011-a886-001ec94ffe7f |
| File Number: | 4397868-2 |
| Registered Office Address: | 2020 E 28th Str #100, Mpls, MN 55407, USA |
| Business Mailing Address: | 1654 Pinehurst Ave, St Paul, MN 55116, USA |
| Principal Executive Office Address: | 2020 E 28th Street #100, Minneapolis, MN 55407, USA |
| ZIP code: | 55407 |
| County: | Hennepin County |
| Place of Formation: | Minnesota |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GREENWAY SURGERY CENTER 401(K) PLAN | 2016 | 452949106 | 2017-10-13 | HIAWATHA SURGERY CENTER, LLC | 30 | |||||||||||||||||||||||||||||||||
|
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| Role | Plan administrator |
| Date | 2017-10-13 |
| Name of individual signing | AMISTYENE JAREMKO |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2017-10-13 |
| Name of individual signing | AMISTYENE JAREMKO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2015-05-01 |
| Business code | 621493 |
| Sponsor’s telephone number | 6127287000 |
| Plan sponsor’s address | 2020 EAST 28TH ST. #100, MINNEAPOLIS, MN, 55407 |
Signature of
| Role | Plan administrator |
| Date | 2017-12-13 |
| Name of individual signing | AMISTYENE JAREMKO |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2017-12-13 |
| Name of individual signing | AMISTYENE JAREMKO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2015-05-01 |
| Business code | 621493 |
| Sponsor’s telephone number | 6127287000 |
| Plan sponsor’s address | 2020 EAST 28TH ST. #100, MINNEAPOLIS, MN, 55407 |
Signature of
| Role | Plan administrator |
| Date | 2016-10-11 |
| Name of individual signing | AMISTYENE JAREMKO |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2016-10-11 |
| Name of individual signing | AMISTYENE JAREMKO |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| W Christopher Urban MD | Manager | PO Box 1708, Pismo Beach, CA 93448, USA |
| Name | Role |
|---|---|
| Amistyene Daniele Jaremko | Agent |
| Filing Name | Filing date |
|---|---|
| Conversion to 322C Due to Statute Mandate – Limited Liability Company (Domestic) | 2018-01-01 |
| Registered Office and/or Agent - Limited Liability Company (Domestic) | 2016-05-12 |
| Annual Reinstatement - Limited Liability Company (Domestic) | 2013-04-18 |
| Administrative Termination - Limited Liability Company (Domestic) | 2013-02-26 |
| Original Filing - Limited Liability Company (Domestic) (Business Name: Hiawatha Surgery Center LLC) | 2011-08-02 |
Date of last update: 28 Dec 2024
Sources: Minnesota's Official State Website
