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BLACKFOOT ANESTHESIA SERVICES, LLC

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Company Details

Name: BLACKFOOT ANESTHESIA SERVICES, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 28 May 2004 (21 years ago)
Financial Date End: 31 May 2026
Entity Number: 105723
Place of Formation: IDAHO
File Number: 105723
ZIP code: 83221
County: Bingham County
Principal Address: PO BOX 829 BLACKFOOT, ID 83221
Mailing Address: PO BOX 829 BLACKFOOT, ID 83221-0829

Agent

Name Role Address
STEVE MCCLELLAN Agent 281 W 200 N, BLACKFOOT, ID 83221

Member

Name Role Address Appointed On Resigned On
Steven D McClellan Member 281 W. 200 N., BLACKFOOT, ID 83221 2021-05-20 No data
Stacey P McClellan Member 281 W. 200 N., BLACKFOOT, ID 83221 2024-04-04 2024-04-04

National Provider Identifier

NPI Number:
1093826513

Authorized Person:

Name:
MR. STEVE MCCLELLAN
Role:
MEMBER
Phone:

Taxonomy:

Selected Taxonomy:
207L00000X - Anesthesiology Physician
Is Primary:
No
Selected Taxonomy:
367500000X - Certified Registered Nurse Anesthetist
Is Primary:
Yes

Contacts:

Fax:
2085232025

Filing

Filing Name Filing Number Filing date
Annual Report 0006192075 2025-04-05
Annual Report 0005672823 2024-04-04
Annual Report 0005179482 2023-04-03
Annual Report 0004682972 2022-04-03
Annual Report 0004287505 2021-05-20

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Date of last update: 26 May 2025

Sources: Idaho Secretary of State