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  5. TREASURE VALLEY PEDIATRICS, P.A.

TREASURE VALLEY PEDIATRICS, P.A.

Company Details

Name: TREASURE VALLEY PEDIATRICS, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 27 Oct 1970 (54 years ago)
Financial Date End: 31 Oct 2013
Date dissolved: 16 Jan 2014
Entity Number: 140904
Place of Formation: IDAHO
File Number: 0000140904
ZIP code: 83642
County: Ada County
Mailing Address: 1620 S CELEBRATION AVE MERIDIAN, ID 83642

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TREASURE VALLEY PEDIATRICS, P.A. 401(K) PS PLAN 2012 820295055 2013-06-18 TREASURE VALLEY PEDIATRICS, P.A. 2
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1972-09-15
Business code 621111
Sponsor’s telephone number 2088841030
Plan sponsor’s address 100 E. IDAHO, STE 401, BOISE, ID, 83712

Signature of
Role Plan administrator
Date 2013-06-18
Name of individual signing GEORGE BOOTH
Valid signature Filed with authorized/valid electronic signature
TREASURE VALLEY PEDIATRICS, P.A. 401(K) PROFIT SHARING PLAN 2012 820295055 2013-01-31 TREASURE VALLEY PEDIATRICS, P.A. 58
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1972-09-15
Business code 621111
Sponsor’s telephone number 2088841030
Plan sponsor’s address 100 E. IDAHO, STE 401, BOISE, ID, 83712

Plan administrator’s name and address
Administrator’s EIN 820295055
Plan administrator’s name TREASURE VALLEY PEDIATRICS, P.A.
Plan administrator’s address 100 E. IDAHO, STE 401, BOISE, ID, 83712
Administrator’s telephone number 2088841030

Signature of
Role Plan administrator
Date 2013-01-31
Name of individual signing GEORGE BOOTH
Valid signature Filed with authorized/valid electronic signature
TREASURE VALLEY PEDIATRICS, P.A. 401(K) PROFIT SHARING PLAN 2011 820295055 2012-07-09 TREASURE VALLEY PEDIATRICS, P.A. 56
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1972-09-15
Business code 621111
Sponsor’s telephone number 2088841030
Plan sponsor’s address 100 E. IDAHO, STE 401, BOISE, ID, 83712

Plan administrator’s name and address
Administrator’s EIN 820295055
Plan administrator’s name TREASURE VALLEY PEDIATRICS, P.A.
Plan administrator’s address 100 E. IDAHO, STE 401, BOISE, ID, 83712
Administrator’s telephone number 2088841030

Signature of
Role Plan administrator
Date 2012-07-09
Name of individual signing GEORGE BOOTH
Valid signature Filed with authorized/valid electronic signature
TREASURE VALLEY PEDIATRICS, P.A. 401(K) PROFIT SHARING PLAN 2010 820295055 2011-05-27 TREASURE VALLEY PEDIATRICS, P.A. 57
Three-digit plan number (PN) 003
Effective date of plan 1972-09-15
Business code 621111
Sponsor’s telephone number 2088841030
Plan sponsor’s address 1620 S. CELEBRATION AVE., MERIDIAN, ID, 83642

Plan administrator’s name and address
Administrator’s EIN 820295055
Plan administrator’s name TREASURE VALLEY PEDIATRICS, P.A.
Plan administrator’s address 1620 S. CELEBRATION AVE., MERIDIAN, ID, 83642
Administrator’s telephone number 2088841030

Signature of
Role Plan administrator
Date 2011-05-27
Name of individual signing GEORGE BOOTH
Valid signature Filed with incorrect/unrecognized electronic signature
TREASURE VALLEY PEDIATRICS, P.A. 401(K) PROFIT SHARING PLAN 2010 820295055 2011-06-20 TREASURE VALLEY PEDIATRICS, P.A. 57
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1972-09-15
Business code 621111
Sponsor’s telephone number 2088841030
Plan sponsor’s address 1620 S. CELEBRATION AVE., MERIDIAN, ID, 83642

Plan administrator’s name and address
Administrator’s EIN 820295055
Plan administrator’s name TREASURE VALLEY PEDIATRICS, P.A.
Plan administrator’s address 1620 S. CELEBRATION AVE., MERIDIAN, ID, 83642
Administrator’s telephone number 2088841030

Signature of
Role Plan administrator
Date 2011-06-20
Name of individual signing GEORGE BOOTH
Valid signature Filed with authorized/valid electronic signature
TREASURE VALLEY PEDIATRICS, P.A. 401(K) PROFIT SHARING PLAN 2010 820295055 2011-05-31 TREASURE VALLEY PEDIATRICS, P.A. 57
Three-digit plan number (PN) 003
Effective date of plan 1972-09-15
Business code 621111
Sponsor’s telephone number 2088841030
Plan sponsor’s address 1620 S. CELEBRATION AVE., MERIDIAN, ID, 83642

Plan administrator’s name and address
Administrator’s EIN 820295055
Plan administrator’s name TREASURE VALLEY PEDIATRICS, P.A.
Plan administrator’s address 1620 S. CELEBRATION AVE., MERIDIAN, ID, 83642
Administrator’s telephone number 2088841030

Signature of
Role Plan administrator
Date 2011-05-31
Name of individual signing GEORGE BOOTH
Valid signature Filed with authorized/valid electronic signature
TREASURE VALLEY PEDIATRICS, P.A. 401(K) PROFIT SHARING PLAN 2009 820295055 2010-07-27 TREASURE VALLEY PEDIATRICS, P.A. 52
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1972-09-15
Business code 621111
Sponsor’s telephone number 2088841030
Plan sponsor’s address 1620 S. CELEBRATION AVE., MERIDIAN, ID, 83642

Plan administrator’s name and address
Administrator’s EIN 820295055
Plan administrator’s name TREASURE VALLEY PEDIATRICS, P.A.
Plan administrator’s address 1620 S. CELEBRATION AVE., MERIDIAN, ID, 83642
Administrator’s telephone number 2088841030

Signature of
Role Plan administrator
Date 2010-07-20
Name of individual signing MINDY GADDIS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-27
Name of individual signing MINDY GADDIS
Valid signature Filed with authorized/valid electronic signature
TREASURE VALLEY PEDIATRICS, P.A. 401(K) PROFIT SHARING PLAN 2009 820295055 2010-07-27 TREASURE VALLEY PEDIATRICS, P.A. 52
Three-digit plan number (PN) 003
Effective date of plan 1972-09-15
Business code 621111
Sponsor’s telephone number 2088841030
Plan sponsor’s address 1620 S. CELEBRATION AVE., MERIDIAN, ID, 83642

Plan administrator’s name and address
Administrator’s EIN 820295055
Plan administrator’s name TREASURE VALLEY PEDIATRICS, P.A.
Plan administrator’s address 1620 S. CELEBRATION AVE., MERIDIAN, ID, 83642
Administrator’s telephone number 2088841030

Signature of
Role Plan administrator
Date 2010-07-20
Name of individual signing MINDY GADDIS
Valid signature Filed with incorrect/unrecognized electronic signature
TREASURE VALLEY PEDIATRICS, P.A. 401(K) PROFIT SHARING PLAN 2009 820295055 2010-07-21 TREASURE VALLEY PEDIATRICS, P.A. 52
Three-digit plan number (PN) 003
Effective date of plan 1972-09-15
Business code 621111
Sponsor’s telephone number 2088841030
Plan sponsor’s address 1620 S. CELEBRATION AVE., MERIDIAN, ID, 83642

Plan administrator’s name and address
Administrator’s EIN 820295055
Plan administrator’s name TREASURE VALLEY PEDIATRICS, P.A.
Plan administrator’s address 1620 S. CELEBRATION AVE., MERIDIAN, ID, 83642
Administrator’s telephone number 2088841030

Signature of
Role Plan administrator
Date 2010-07-20
Name of individual signing MINDY GADDIS
Valid signature Filed with incorrect/unrecognized electronic signature

Filing

Filing Name Filing Number Filing date
Annual Report 0001464848 2012-08-23
Annual Report 0001464841 2011-08-15
Annual Report 0001464839 2010-08-09
Annual Report 0001464837 2009-09-16
Annual Report 0001464844 2008-09-18
Annual Report 0001464843 2007-10-10
Annual Report 0001464825 2006-08-09
Annual Report 0001464823 2005-08-12
Annual Report 0001464822 2004-08-23
Annual Report 0001464821 2003-08-14

Related by officers

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Date of last update: 23 Sep 2024

Sources: Idaho Secretary of State

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