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MOSCOW MEDICAL, P.A.

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Company Details

Name: MOSCOW MEDICAL, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 11 Sep 1975 (50 years ago)
Financial Date End: 30 Sep 2026
Entity Number: 167729
Place of Formation: IDAHO
File Number: 167729
ZIP code: 83843
County: Latah County
Mailing Address: 213 N MAIN ST MOSCOW, ID 83843-2700

Agent

Name Role Address
TRACY L PAZ Agent 213 N MAIN ST, MOSCOW, ID 83843

Treasurer

Name Role Address Appointed On Resigned On
Tracy Paz Treasurer 213 N MAIN ST, MOSCOW, ID 83843 2023-08-31 2024-08-06

Secretary

Name Role Address Appointed On Resigned On
Megan Neilson Secretary 213 N MAIN ST, MOSCOW, ID 83843 2023-08-31 2024-08-06

President

Name Role Address Appointed On
Raymond M Paz President 213 N MAIN ST, MOSCOW, ID 83843 2021-09-07
Raymond M Paz M.D. President 213 N MAIN ST, MOSCOW, ID 83843 2020-09-01

U.S. Small Business Administration Profile

Phone Number:
E-mail Address:
Contact Person:
TRACY PAZ
Ownership and Self-Certifications:
Hispanic American, Other Minority Owned
User ID:
P2788907

Unique Entity ID

Unique Entity ID:
S8ENT6UYNQX3
CAGE Code:
92L10
UEI Expiration Date:
2026-07-01

Business Information

Division Name:
MOSCOW MEDICAL, P.A.
Activation Date:
2025-07-03
Initial Registration Date:
2021-06-24

Commercial and government entity program

CAGE number:
92L10
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2025-07-03
CAGE Expiration:
2030-07-03
SAM Expiration:
2026-07-01

Contact Information

POC:
TRACY PAZ
Corporate URL:
www.moscowmedical.com

National Provider Identifier

NPI Number:
1871646976

Authorized Person:

Name:
MRS. KATHY CORNISH
Role:
BILLING MANAGER
Phone:

Taxonomy:

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

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006376718 2025-08-01
Annual Report 0005849336 2024-08-06
Annual Report 0005376764 2023-08-31
Annual Report 0004852937 2022-08-08
Annual Report 0004409446 2021-09-07

USAspending Awards / Financial Assistance

Date:
2020-04-29
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
10000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-27
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
150300.00
Total Face Value Of Loan:
150300.00
Date:
2010-03-23
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES WHICH ARE UNABLE TO OBTAIN FINANCING IN THE PRIVATE CREDIT MARKETPLACE
Obligated Amount:
0.00
Face Value Of Loan:
35000.00
Total Face Value Of Loan:
35000.00

Paycheck Protection Program

Jobs Reported:
15
Initial Approval Amount:
$150,300
Date Approved:
2020-04-27
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$150,300
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$151,103.74
Servicing Lender:
Umpqua Bank
Use of Proceeds:
Payroll: $150,300

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Date of last update: 01 Aug 2025

Sources: Idaho Secretary of State