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CHARLES P. LAWLESS, M.D., P.A.

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Company Details

Name: CHARLES P. LAWLESS, M.D., P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 11 Aug 1977 (48 years ago)
Financial Date End: 31 Aug 2021
Date dissolved: 17 Nov 2021
Entity Number: 180274
Place of Formation: IDAHO
File Number: 180274
ZIP code: 83201
County: Bannock County
Mailing Address: STE 310 1777 E CLARK ST POCATELLO, ID 83201-3357

Agent

Name Role Address
CHARLES P. LAWLESS M.D. Agent 1777 EAST CLARK STREET, STE 310, POCATELLO, ID 83201

President

Name Role Address Appointed On
CHARLES P LAWLESS President 1667 RUBY, POCATELLO, ID 83201 2020-08-05

National Provider Identifier

NPI Number:
1629280359

Authorized Person:

Name:
DR. CHARLES PITTMAN LAWLESS
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
174400000X - Specialist
Is Primary:
Yes

Contacts:

Fax:
2082335736

Form 5500 Series

Employer Identification Number (EIN):
820334175
Plan Year:
2019
Number Of Participants:
1
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
2
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
3
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0004499828 2021-11-17
Annual Report 0003960672 2020-08-05
Annual Report 0003585415 2019-08-01
Annual Report 0001635544 2018-06-28
Annual Report 0001635543 2017-06-28

USAspending Awards / Financial Assistance

Date:
2020-09-09
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO PROVIDE LOANS TO RESTORE AS NEARLY AS POSSIBLE THE VICTIMS OF ECONOMIC INJURY TYPE DISASTERS TO PRE-DISASTER CONDITIONS
Obligated Amount:
0.00
Face Value Of Loan:
15100.00
Total Face Value Of Loan:
15100.00
Date:
2020-04-11
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:
22233.00
Total Face Value Of Loan:
22233.00

Paycheck Protection Program

Date Approved:
2020-04-11
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
22233
Current Approval Amount:
22233
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
22517.46

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Date of last update: 28 May 2025

Sources: Idaho Secretary of State