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  5. EASTERN IDAHO SPINE CENTER PLLC

EASTERN IDAHO SPINE CENTER PLLC

Company Details

Name: EASTERN IDAHO SPINE CENTER PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 11 Feb 2008 (17 years ago)
Financial Date End: 28 Feb 2017
Date dissolved: 05 Jun 2017
Entity Number: 224212
Place of Formation: IDAHO
File Number: 0000224212
ZIP code: 83404
County: Bonneville County
Principal Address: 2730 HOMESTEAD LN IDAHO FALLS, ID 83404

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EASTERN IDAHO SPINE CENTER, PLLC 401(K) PLAN 2014 261906740 2015-06-11 EASTERN IDAHO SPINE CENTER, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2085354343
Plan sponsor’s address 3155 CHANNING WAY, SUITE A, IDAHO FALLS, ID, 83404

Signature of
Role Plan administrator
Date 2015-06-10
Name of individual signing MARK HOLBROOK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-06-10
Name of individual signing MARK HOLBROOK
Valid signature Filed with authorized/valid electronic signature
EASTERN IDAHO SPINE CENTER, PLLC 401(K) PLAN 2013 261906740 2014-07-24 EASTERN IDAHO SPINE CENTER, PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2085354343
Plan sponsor’s address 3155 CHANNING WAY, SUITE A, IDAHO FALLS, ID, 83404

Signature of
Role Plan administrator
Date 2014-07-24
Name of individual signing MARK HOLBROOK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-24
Name of individual signing MARK HOLBROOK
Valid signature Filed with authorized/valid electronic signature
EASTERN IDAHO SPINE CENTER, PLLC 401(K) PLAN 2012 261906740 2013-10-14 EASTERN IDAHO SPINE CENTER, PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2085354343
Plan sponsor’s address 3155 CHANNING WAY, SUITE A, IDAHO FALLS, ID, 83404

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing MARK HOLBROOK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-14
Name of individual signing MARK HOLBROOK
Valid signature Filed with authorized/valid electronic signature
EASTERN IDAHO SPINE CENTER, PLLC 401(K) PLAN 2011 261906740 2012-06-01 EASTERN IDAHO SPINE CENTER, PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2085354343
Plan sponsor’s address 3155 CHANNING WAY, SUITE A, IDAHO FALLS, ID, 83404

Plan administrator’s name and address
Administrator’s EIN 261906740
Plan administrator’s name EASTERN IDAHO SPINE CENTER, PLLC
Plan administrator’s address 3155 CHANNING WAY, SUITE A, IDAHO FALLS, ID, 83404
Administrator’s telephone number 2085354343

Signature of
Role Plan administrator
Date 2012-06-01
Name of individual signing MARK HOLBROOK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-06-01
Name of individual signing MARK HOLBROOK
Valid signature Filed with authorized/valid electronic signature
EASTERN IDAHO SPINE CENTER, PLLC 401(K) PLAN 2010 261906740 2011-07-01 EASTERN IDAHO SPINE CENTER, PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2085354343
Plan sponsor’s address 3155 CHANNING WAY, SUITE A, IDAHO FALLS, ID, 83404

Plan administrator’s name and address
Administrator’s EIN 261906740
Plan administrator’s name EASTERN IDAHO SPINE CENTER, PLLC
Plan administrator’s address 3155 CHANNING WAY, SUITE A, IDAHO FALLS, ID, 83404
Administrator’s telephone number 2085354343

Signature of
Role Plan administrator
Date 2011-07-01
Name of individual signing MARK HOLBROOK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-01
Name of individual signing MARK HOLBROOK
Valid signature Filed with authorized/valid electronic signature

Filing

Filing Name Filing Number Filing date
Annual Report 0001820309 2015-12-21
Statement of Change of Business Mailing Address 0001820307 2015-04-06
Change of Registered Office/Agent/Both (by Entity) 0001820308 2015-04-06
Legacy Amendment 0000807216 2015-04-03
Annual Report 0001820306 2015-02-04
Annual Report 0001820305 2014-04-08
Annual Report 0001820304 2013-02-28
Annual Report 0001820313 2012-02-15
Annual Report 0001820312 2011-03-01
Annual Report 0001820311 2010-02-26

Related by officers

No related officers

Related by address

2730 HOMESTEAD LN IDAHO FALLS, ID 83404

QUILTED DAISY (THE) QUILTED DAISY, INC. (THE)

Date of last update: 24 Sep 2024

Sources: Idaho Secretary of State

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