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LIBERTY DIALYSIS-NAMPA LLC

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Company Details

Name: LIBERTY DIALYSIS-NAMPA LLC
Jurisdiction: Idaho
Legal type: Foreign Limited Liability Company
Status: Active-Existing
Date of registration: 22 Nov 2006 (19 years ago)
Financial Date End: 30 Nov 2025
Entity Number: 180638
Place of Formation: DELAWARE
File Number: 180638
Principal Address: 920 WINTER ST TAX DEPT WALTHAM, MA 2451
Mailing Address: 920 WINTER STREET, WALTHAM,, MA 02451

Member

Name Role Address Appointed On
Boise Dialysis LLC Member 920 WINTER ST, WALTHAM, MA 02451-1521 2020-11-25

Agent

Name Role Address
BOISE DIALYSIS Agent MICHELLE NELSON, 3525 E LOUISE DR STE 100, MERIDIAN, ID 83642

National Provider Identifier

NPI Number:
1396802070
Certification Date:
2023-10-17

Authorized Person:

Name:
BARRY L. BLANTON
Role:
VICE PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2084638560

Filing

Filing Name Filing Number Filing date
Annual Report 0005941995 2024-10-15
Annual Report 0005435641 2023-10-09
Annual Report 0004939553 2022-10-05
Annual Report 0004432785 2021-10-02
Annual Report 0004074627 2020-11-25

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Date of last update: 28 May 2025

Sources: Idaho Secretary of State