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IDAHO EMERGENCY PHYSICIANS, P.A.

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Company Details

Name: IDAHO EMERGENCY PHYSICIANS, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved
Date of registration: 25 Oct 1974 (51 years ago)
Financial Date End: 31 Oct 2020
Date dissolved: 27 Dec 2019
Entity Number: 162572
Place of Formation: IDAHO
File Number: 0000162572
Mailing Address: STE 156 410 S ORCHARD ST BOISE, ID 83705-1210

Agent

Name Role Address
JOSEPH A. UBERUAGA, II Agent 1111 W JEFFERSON SUITE 530, BOISE, ID 83702

Unique Entity ID

CAGE Code:
39YZ4
UEI Expiration Date:
2017-07-13

Business Information

Activation Date:
2016-07-13
Initial Registration Date:
2005-05-19

Commercial and government entity program

CAGE number:
39YZ4
Status:
Obsolete
Type:
Non-Manufacturer
CAGE Update Date:
2022-02-16
CAGE Expiration:
2022-02-15

Contact Information

POC:
CATHERINE MUMM

National Provider Identifier

NPI Number:
1730133208

Authorized Person:

Name:
BRANDON WILIDING
Role:
CHAIRMAN AND PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207P00000X - Emergency Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
2083221731

Form 5500 Series

Employer Identification Number (EIN):
820312175
Plan Year:
2013
Number Of Participants:
62
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
52
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
52
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
54
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
47
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Articles of Dissolution 0003719148 2019-12-27
Annual Report 0003677127 2019-11-14
Annual Report 0001558955 2018-08-27
Annual Report 0001558954 2017-08-22
Annual Report 0001558953 2016-09-06

USAspending Awards / Contracts

Procurement Instrument Identifier:
AG84M8P150004
Award Or Idv Flag:
AWARD
Award Type:
PO
Action Obligation:
30900.00
Base And Exercised Options Value:
30900.00
Base And All Options Value:
30900.00
Awarding Agency Name:
Department of Agriculture
Performance Start Date:
2015-09-11
Description:
IGF::OT::IGF EMERGENCY MEDICAL DIRECTOR FOR FOREST SERVICE EMTS
Naics Code:
621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product Or Service Code:
Q999: MEDICAL- OTHER

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Date of last update: 23 Sep 2024

Sources: Idaho Secretary of State