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FAMILY MEDICAL CENTER, PLLC

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Company Details

Name: FAMILY MEDICAL CENTER, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved
Date of registration: 11 Jan 2006 (20 years ago)
Financial Date End: 31 Jan 2013
Date dissolved: 31 Jul 2012
Entity Number: 150815
Place of Formation: IDAHO
File Number: 0000150815
ZIP code: 83672
County: Washington County
Principal Address: 360 E LIBERTY WEISER, ID 83672

National Provider Identifier

NPI Number:
1972545556

Authorized Person:

Name:
DR. BRYAN L DRAKE
Role:
PARTNER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
2084140947

Filing

Filing Name Filing Number Filing date
Statement of Dissolution 0000751265 2012-07-31
Annual Report 0001506745 2012-01-30
Annual Report 0001506744 2010-11-30
Annual Report 0001506743 2009-11-10
Annual Report 0001506747 2008-11-21

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Date of last update: 23 Sep 2024

Sources: Idaho Secretary of State