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TAMARACK MEDICAL CLINIC, LLC

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Company Details

Name: TAMARACK MEDICAL CLINIC, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved
Date of registration: 20 Sep 2004 (21 years ago)
Financial Date End: 30 Sep 2020
Date dissolved: 10 Dec 2019
Entity Number: 112783
Place of Formation: IDAHO
File Number: 0000112783
ZIP code: 83706
County: Ada County
Principal Address: 1055 N CURTIS RD BOISE, ID 83706
Mailing Address: 1055 N CURTIS RD BOISE, ID 83706-1309

Agent

Name Role Address
Odette C. Bolano Agent 1055 N CURTIS ROAD, BOISE, ID 83706-1309

National Provider Identifier

NPI Number:
1437214475

Authorized Person:

Name:
MR. WILLIAM BEHNKE
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
261QU0200X - Urgent Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2083823580

Filing

Filing Name Filing Number Filing date
Statement of Dissolution 0003705031 2019-12-10
Application for Reinstatement 0003681971 2019-12-05
Annual Report 0001348319 2011-09-20
Change of Registered Office/Agent/Both (by Entity) 0001348320 2010-10-28
Annual Report 0001348318 2010-10-11

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Date of last update: 23 Sep 2024

Sources: Idaho Secretary of State