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NORTHRIDGE INTERNAL MEDICINE, PLLC

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Company Details

Name: NORTHRIDGE INTERNAL MEDICINE, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 24 Aug 2007 (18 years ago)
Financial Date End: 31 Aug 2010
Date dissolved: 10 Nov 2010
Entity Number: 209063
Place of Formation: IDAHO
File Number: 0000209063
ZIP code: 83440
County: Madison County
Principal Address: 36 PROFESSIONAL PLAZA STE 102 REXBURG, ID 83440

National Provider Identifier

NPI Number:
1033394713

Authorized Person:

Name:
RODNEY BATES
Role:
MEMBER
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
2086568444

Filing

Filing Name Filing Number Filing date
Annual Report 0001755869 2009-06-16
Annual Report 0001755870 2008-07-07
Legacy Amendment 0000798414 2007-10-29
Initial Filing 0000209063 2007-08-24

USAspending Awards / Financial Assistance

Date:
2007-11-06
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES WHICH ARE UNABLE TO OBTAIN FINANCING IN THE PRIVATE CREDIT MARKETPLACE
Obligated Amount:
0.00
Face Value Of Loan:
100000.00
Total Face Value Of Loan:
100000.00

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Date of last update: 24 Sep 2024

Sources: Idaho Secretary of State