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MERIDIAN ADULT MEDICINE, PLLC

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Company Details

Name: MERIDIAN ADULT MEDICINE, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 01 Jun 2004 (21 years ago)
Financial Date End: 30 Jun 2011
Date dissolved: 07 Sep 2011
Entity Number: 105926
Place of Formation: IDAHO
File Number: 0000105926
ZIP code: 83642
County: Ada County
Principal Address: 520 S EAGLE RD #1221 MERIDIAN, ID 83642

National Provider Identifier

NPI Number:
1619921202

Authorized Person:

Name:
DR. LOUIS MICHAEL SCHLICKMAN
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
2088845602

Form 5500 Series

Employer Identification Number (EIN):
201188708
Plan Year:
2010
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2009
Number Of Participants:
10
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Legacy Amendment 0001319816 2011-07-14
Annual Report 0001319815 2010-04-09
Annual Report 0001319814 2009-04-14
Annual Report 0001319818 2008-04-22
Annual Report 0001319817 2007-04-10

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Date of last update: 23 Sep 2024

Sources: Idaho Secretary of State