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SOUTHEAST IDAHO GASTROENTEROLOGY, P.L.L.C.

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Company Details

Name: SOUTHEAST IDAHO GASTROENTEROLOGY, P.L.L.C.
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved
Date of registration: 29 Oct 1996 (29 years ago)
Financial Date End: 31 Oct 2018
Date dissolved: 22 Nov 2017
Entity Number: 19701
Place of Formation: IDAHO
File Number: 0000019701
ZIP code: 83201
County: Bannock County
Principal Address: 1151 HOSPITAL WAY BLDG A POCATELLO, ID 83201

National Provider Identifier

NPI Number:
1295754265

Authorized Person:

Name:
DARRYL BRUCE COOK
Role:
MEMBER
Phone:

Taxonomy:

Selected Taxonomy:
207RG0100X - Gastroenterology Physician
Is Primary:
Yes

Contacts:

Fax:
2082326618

Filing

Filing Name Filing Number Filing date
Statement of Dissolution 0000648454 2017-11-22
Annual Report 0000999626 2017-11-20
Annual Report 0000999625 2016-08-30
Annual Report 0000999619 2015-08-17
Annual Report 0000999624 2014-08-26

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Date of last update: 22 Sep 2024

Sources: Idaho Secretary of State