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SAINT ALPHONSUS MEDICAL CENTER - NAMPA, INC.

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Company Details

Name: SAINT ALPHONSUS MEDICAL CENTER - NAMPA, INC.
Jurisdiction: Idaho
Legal type: Non-Profit Corporation (D)
Status: Active-Good Standing
Date of registration: 31 Aug 1965 (60 years ago)
Financial Date End: 31 Aug 2025
Entity Number: 122785
Place of Formation: IDAHO
File Number: 122785
ZIP code: 83687
County: Canyon County
Mailing Address: 4300 E FLAMINGO AVE NAMPA, ID 83687-3138

Agent

Name Role Address
C T CORPORATION SYSTEM Agent 10020 W FAIRVIEW AVE, STE 104, BOISE, ID 83704

President

Name Role Address Appointed On Resigned On
TRAVIS LEACH President 4300 E. FLAMINGO AVENUE, NAMPA, ID 83687 2020-08-31 2023-08-28
Clint Child President 4300 E FLAMINGO AVE, NAMPA, ID 83687-3138 2023-08-28 No data

Secretary

Name Role Address Appointed On
STEPHANIE WESTERMEIER Secretary 1055 N. CURTIS ROAD, BOISE, ID 83706 2023-08-28

Director

Name Role Address Appointed On
MICHAEL BALLANTINE Director 1055 N. CURTIS ROAD, BOISE, ID 83706 2023-08-28
ANABEL ORTIZ-CHAVOLLA Director 1055 N. CURTIS ROAD, BOISE, ID 83706 2023-08-28
TONI NIELSEN Director 1055 N. CURTIS ROAD, BOISE, ID 83706 2023-08-28
SUSAN MORRIS Director 1055 N. CURTIS ROAD, BOISE, ID 83706 2023-08-28
LUPE WISSEL Director 1055 N. CURTIS ROAD, BOISE, ID 83706 2023-08-28
SR. SUZANNE BRENNAN Director 1055 N. CURTIS ROAD, BOISE, ID 83706 2023-08-28
KIRK JACOBSON Director 1055 N. CURTIS ROAD, BOISE, ID 83706 2023-08-28
ADAM RICHINS Director 1055 N. CURTIS ROAD, BOISE, ID 83706 2023-08-28
MICHAEL COUGHLIN, MD Director 1055 N. CURTIS ROAD, BOISE, ID 83706 2023-08-28
ANGELA TAYLOR Director 1055 N. CURTIS ROAD, BOISE, ID 83706 2023-08-28

Treasurer

Name Role Address Appointed On
B. LANNIE CHECKETTS Treasurer 1055 N. CURTIS ROAD, BOISE, ID 83706 2023-08-28

Unique Entity ID

Unique Entity ID:
ZD2QQVZ76JY5
CAGE Code:
9QGQ9
UEI Expiration Date:
2026-04-25

Business Information

Activation Date:
2025-04-29
Initial Registration Date:
2023-10-19

National Provider Identifier

NPI Number:
1114223807
Certification Date:
2023-01-24

Authorized Person:

Name:
BRIAN LANNIE CHECKETTS
Role:
CFO
Phone:

Taxonomy:

Selected Taxonomy:
282N00000X - General Acute Care Hospital
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Registered Agent Name/Address Change (mass change) 0006275643 2025-05-27
Annual Report 0005868327 2024-08-22
Annual Report 0005373358 2023-08-28
Registered Agent Name/Address Change (mass change) 0004897945 2022-09-12
Annual Report 0004874898 2022-09-01

Tax Exempt

Employer Identification Number (EIN) :
82-0200896
In Care Of Name:
% PRESIDENT CEO
Classification:
Government Instrumentality, Title-Holding Corporation, Charitable Organization, Educational Organization, Local Association of Employees, Agricultural Organization, Horticultural Organization, Board of Trade, Business League, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Voluntary Employees' Beneficiary Association (Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Mutual Ditch or Irrigation Co., Burial Association, Cemetery Company, Credit Union, Other Mutual Corp. or Assoc., 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

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Date of last update: 15 Jul 2025

Sources: Idaho Secretary of State