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  5. ST. MARY'S HOSPITAL, INC.

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

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

Business Information

URL:
www.smh-cvhc.org
Activation Date:
2024-12-05
Initial Registration Date:
2004-03-30

Commercial and government entity program

CAGE number:
3TDF9
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2024-12-05
CAGE Expiration:
2029-12-05
SAM Expiration:
2025-12-03

Contact Information

POC:
JYL RULAND
Corporate URL:
www.smh-cvhc.org

National Provider Identifier

NPI Number:
1710203237
Certification Date:
2020-10-02
Link:
View on NPI website

Authorized Person:

Name:
MICHELLE M GATES
Role:
DIRECTOR OF REVENUE CYCLE
Phone:
2084768083

Taxonomy:

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

Contacts:

Phone:
+1 208-962-3267
Fax:
2089622313

Form 5500 Series

Employer Identification Number (EIN):
820226453
Plan Year:
2015
Number Of Participants:
289
Sponsors Telephone Number:
2089622318
File:
View File
Plan Year:
2014
Number Of Participants:
281
Sponsors Telephone Number:
2089622318
File:
View File

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
Link:
View on USAspending
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
Link:
View on USAspending
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
Link:
View on USAspending
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
Link:
View on USAspending
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
Link:
View on USAspending
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

Tax Exempt

Employer Identification Number (EIN) :
82-0226453
In Care Of Name:
% LENNE BONNER
Classification:
Government Instrumentality, Title-Holding Corporation, Charitable Organization, Religious Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Ruling Date:
1946-03

Paycheck Protection Program

Jobs Reported:
205
Initial Approval Amount:
$2,287,124
Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$2,287,124
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$2,313,190.95
Servicing Lender:
Potlatch No. 1 Financial Credit Union
Use of Proceeds:
Payroll: $2,287,124

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Date of last update: 15 Jul 2025

Sources: Idaho Secretary of State

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