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RADIOLOGY PHYSICIANS OF IDAHO, PC

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Company Details

Name: RADIOLOGY PHYSICIANS OF IDAHO, PC
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 12 Jul 1977 (48 years ago)
Financial Date End: 31 Jul 2016
Date dissolved: 15 Nov 2016
Entity Number: 179635
Place of Formation: IDAHO
File Number: 0000179635
ZIP code: 83201
County: Bannock County
Mailing Address: 1151 HOSPITAL WAY BUILDING 'B' 2ND FLOOR POCATELLO, ID 83201

National Provider Identifier

NPI Number:
1952377459

Authorized Person:

Name:
STEVEN A. LARSEN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
2085R0202X - Diagnostic Radiology Physician
Is Primary:
Yes

Contacts:

Fax:
2082343841

Filing

Filing Name Filing Number Filing date
Annual Report 0001632971 2015-07-24
Annual Report 0001632970 2014-07-24
Annual Report 0001632969 2013-06-25
Annual Report 0001632986 2012-06-12
Change of Registered Office/Agent/Both (by Entity) 0001632981 2012-01-24

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Date of last update: 24 Sep 2024

Sources: Idaho Secretary of State