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ST. MARY'S HOSPITAL, INC.

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Company Details

Name: ST. MARY'S HOSPITAL, INC.
Jurisdiction: Idaho
Legal type: Non-Profit Corporation (D)
Status: Active-Good Standing
Date of registration: 24 Jan 1958 (67 years ago)
Financial Date End: 31 Jan 2026
Entity Number: 102305
Place of Formation: IDAHO
File Number: 102305
ZIP code: 83522
County: Idaho County
Mailing Address: 701 LEWISTON ST COTTONWOOD, ID 83522-9750

Agent

Name Role Address
Joel P Hazel Agent 2003 KOOTENAI HEALTH WAY, STE 107, COEUR D ALENE, ID 83814

Director

Name Role Address Appointed On Resigned On
Matt Sartini Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2021-01-22 No data
Paul Nusser Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03
Rene Forsman Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03
Kim Ingram Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03
Kelly McGrath Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03
Jeremy Evans Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03
Cindy O'Brien Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03
Tina Ulmer Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03
Lisa Maurer Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03
Barbara Jean Glodowski Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
DKW1MZFJAB38
CAGE Code:
3TDF9
UEI Expiration Date:
2025-12-03

Business Information

Activation Date:
2024-12-05
Initial Registration Date:
2004-03-30

National Provider Identifier

NPI Number:
1710203237
Certification Date:
2020-10-02

Authorized Person:

Name:
MICHELLE M GATES
Role:
DIRECTOR OF REVENUE CYCLE
Phone:

Taxonomy:

Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
2089622313

Form 5500 Series

Employer Identification Number (EIN):
820226453
Plan Year:
2015
Number Of Participants:
289
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
281
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0006042281 2025-01-02
Annual Report 0005535832 2024-01-03
Annual Report 0005031416 2022-12-15
Annual Report 0004579336 2022-01-24
Annual Report 0004141497 2021-01-22

USAspending Awards / Financial Assistance

Date:
2020-04-15
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
2287124.00
Total Face Value Of Loan:
2287124.00
Date:
2019-03-01
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
RURAL BENEFITS COUNSELING PROGRAM
Obligated Amount:
0.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2015-07-23
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
RURAL BENEFITS COUNSELING PROGRAM
Obligated Amount:
225000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2018-10-01
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM
Obligated Amount:
0.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2015-04-24
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM
Obligated Amount:
600000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00

OSHA's Inspections within Industry

Inspection Summary

Date:
2022-01-28
Type:
Fat/Cat
Address:
701 LEWISTON STREET, COTTONWOOD, ID, 83522
Safety Health:
Health
Scope:
Partial

Paycheck Protection Program

Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
2287124
Current Approval Amount:
2287124
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
2313190.95

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Date of last update: 26 May 2025

Sources: Idaho Secretary of State