| Name: | MEDICINE MAN PHARMACY, INC. |
| Jurisdiction: | Idaho |
| Legal type: | General Business Corporation (D) |
| Status: | Active-Good Standing |
| Date of registration: | 02 Nov 1981 (43 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 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MEDICINE MAN PHARMACY, INC. 401(K) PLAN | 2012 | 820440746 | 2013-06-25 | MEDICINE MAN PHARMACY, INC. | 32 | |||||||||||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2013-06-25 |
| Name of individual signing | BARRY FEELY |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2013-06-25 |
| Name of individual signing | BARRY FEELY |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2002-05-01 |
| Business code | 446110 |
| Sponsor’s telephone number | 2087629355 |
| Plan sponsor’s address | 8093 CORNERSTONE DRIVE, HAYDEN, ID, 838358753 |
Plan administrator’s name and address
| Administrator’s EIN | 820440746 |
| Plan administrator’s name | MEDICINE MAN PHARMACY, INC. |
| Plan administrator’s address | 8093 CORNERSTONE DRIVE, HAYDEN, ID, 838358753 |
| Administrator’s telephone number | 2087629355 |
Signature of
| Role | Plan administrator |
| Date | 2012-06-27 |
| Name of individual signing | BARRY FEELY |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2012-06-27 |
| Name of individual signing | BARRY FEELY |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2002-05-01 |
| Business code | 446110 |
| Sponsor’s telephone number | 2087629355 |
| Plan sponsor’s address | 8093 CORNERSTONE DRIVE, HAYDEN, ID, 838358753 |
Plan administrator’s name and address
| Administrator’s EIN | 820440746 |
| Plan administrator’s name | MEDICINE MAN PHARMACY, INC. |
| Plan administrator’s address | 8093 CORNERSTONE DRIVE, HAYDEN, ID, 838358753 |
| Administrator’s telephone number | 2087629355 |
Signature of
| Role | Plan administrator |
| Date | 2011-05-25 |
| Name of individual signing | BARRY FEELY |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2011-05-25 |
| Name of individual signing | BARRY FEELY |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| BRIAN MITCHELL JORGENSEN | Agent | 1114 IRONWOOD DRIVE, COEUR D'ALENE, ID 83814 |
| Name | Role | Address | Appointed On |
|---|---|---|---|
| Brian M Jorgensen | President | 1686 W BELLERIVE LN, COEUR D'ALENE, ID 83814 | 2020-10-05 |
| 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 |
| 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 |
| 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 |
| 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 |
| Annual Report | 0003654489 | 2019-10-24 |
| Annual Report | 0003323875 | 2018-10-15 |
| Annual Report | 0001782987 | 2017-09-19 |
| Annual Report | 0001782985 | 2016-09-27 |
| Annual Report | 0001782982 | 2015-09-18 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5083128108 | 2020-07-17 | 1094 | PPP | 1114 W IRONWOOD DR, COEUR D ALENE, ID, 83814-2605 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Apr 2025
Sources: Idaho Secretary of State
