Search icon

MEDICINE MAN PHARMACY, INC.

Company claim

Is this your business?

Get access!

Company Details

Name: MEDICINE MAN PHARMACY, INC.
Jurisdiction: Idaho
Legal type: General Business Corporation (D)
Status: Active-Good Standing
Date of registration: 02 Nov 1981 (44 years ago)
Financial Date End: 30 Nov 2025
Entity Number: 215601
Place of Formation: IDAHO
File Number: 215601
ZIP code: 83814
County: Kootenai County
Mailing Address: 1114 W IRONWOOD DR COEUR D ALENE, ID 83814-2605

Agent

Name Role Address
BRIAN MITCHELL JORGENSEN Agent 1114 IRONWOOD DRIVE, COEUR D'ALENE, ID 83814

President

Name Role Address Appointed On
Brian M Jorgensen President 1686 W BELLERIVE LN, COEUR D'ALENE, ID 83814 2020-10-05

Treasurer

Name Role Address Appointed On Resigned On
Brian M Jorgensen Treasurer 1686 W BELLERIVE LN, COEUR D'ALENE, ID 83814 2023-10-10 2023-10-10

Secretary

Name Role Address Appointed On Resigned On
Jodi W Johnson Secretary 9030 E RIVERVIEW, COEUR D ALENE, ID 83814 2023-10-10 2023-10-10

Director

Name Role Address Appointed On Resigned On
Mattie W Jorgensen Director 6462 W BUFFALO GRASS LN, RATHDRUM, ID 83858 2023-10-10 2023-10-10

National Provider Identifier

NPI Number:
1750493698

Authorized Person:

Name:
BRIAN JORGENSEN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
333600000X - Pharmacy
Is Primary:
No
Selected Taxonomy:
3336C0003X - Community/Retail Pharmacy
Is Primary:
Yes

Contacts:

Fax:
2086675921

Form 5500 Series

Employer Identification Number (EIN):
820440746
Plan Year:
2012
Number Of Participants:
32
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
32
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
33
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0005948108 2024-10-22
Annual Report 0005436420 2023-10-10
Annual Report 0004959864 2022-10-24
Annual Report 0004435444 2021-10-04
Annual Report 0004023746 2020-10-05

USAspending Awards / Financial Assistance

Date:
2020-07-17
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:
135760.00
Total Face Value Of Loan:
135760.00

Paycheck Protection Program

Date Approved:
2020-07-17
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
135760
Current Approval Amount:
135760
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
136507.61

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 29 May 2025

Sources: Idaho Secretary of State