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BOISE PATHOLOGY GROUP, P.A.

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Company Details

Name: BOISE PATHOLOGY GROUP, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 21 Oct 1976 (49 years ago)
Financial Date End: 31 Oct 2025
Entity Number: 174676
Place of Formation: IDAHO
File Number: 174676
ZIP code: 83712
County: Ada County
Mailing Address: 190 E BANNOCK ST BOISE, ID 83712-6241

Agent

Name Role Address
Daniel J Walsh Agent 190 E BANNOCK ST, BOISE, ID 83712

President

Name Role Address Appointed On
Daniel J Walsh President 190 E BANNOCK ST., BOISE, ID 83712 2020-09-15

National Provider Identifier

NPI Number:
1063466225

Authorized Person:

Name:
DR. RICHARD STILLINGER
Role:
SECRETARY-TREASURER
Phone:

Taxonomy:

Selected Taxonomy:
207ZC0500X - Cytopathology Physician
Is Primary:
No
Selected Taxonomy:
207ZH0000X - Hematology (Pathology) Physician
Is Primary:
No
Selected Taxonomy:
207ZP0102X - Anatomic Pathology & Clinical Pathology Physician
Is Primary:
No
Selected Taxonomy:
207ZD0900X - Dermatopathology (Pathology) Physician
Is Primary:
No

Contacts:

Fax:
2083441926

Form 5500 Series

Employer Identification Number (EIN):
820328732
Plan Year:
2023
Number Of Participants:
14
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0005883194 2024-09-04
Annual Report 0005389094 2023-09-07
Annual Report 0004957496 2022-10-20
Annual Report 0004411780 2021-09-08
Annual Report 0004004345 2020-09-15

USAspending Awards / Contracts

Procurement Instrument Identifier:
VA531C94031
Award Or Idv Flag:
AWARD
Award Type:
PURCHASE ORDER
Action Obligation:
3600.00
Base And Exercised Options Value:
3600.00
Base And All Options Value:
3600.00
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2008-10-01
Description:
PATHOLOGY LAB TESTING
Naics Code:
621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product Or Service Code:
Q301: LABORATORY TESTING SERVICES

USAspending Awards / Financial Assistance

Date:
2020-04-09
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:
302130.00
Total Face Value Of Loan:
302130.00

Paycheck Protection Program

Date Approved:
2020-04-09
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
302130
Current Approval Amount:
302130
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
304083.5

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Date of last update: 28 May 2025

Sources: Idaho Secretary of State