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ADVANCED EYECARE OF BLACKFOOT, PLLC

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Company Details

Name: ADVANCED EYECARE OF BLACKFOOT, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 25 Aug 2008 (17 years ago)
Financial Date End: 31 Aug 2025
Entity Number: 241564
Place of Formation: IDAHO
File Number: 241564
ZIP code: 83221
County: Bingham County
Principal Address: 1213 PARKWAY DRIVE BLACKFOOT, ID 83221
Mailing Address: 593 W BRIDGE ST BLACKFOOT, ID 83221-2016

Agent

Name Role Address
Jason Hurley Agent 506 NORTH 4000 EAST, RIGBY, ID 83442

Manager

Name Role Address Appointed On
Jeremy B Ball Manager 4021 E 66 N, RIGBY, ID 83442 2023-10-11
Jason Hurley Manager 711 RIGBY LAKE DR STE 301, RIGBY, ID 83442-5334 2020-07-05

National Provider Identifier

NPI Number:
1568610574

Authorized Person:

Name:
DR. JERRY CARLSON
Role:
DOCTOR
Phone:

Taxonomy:

Selected Taxonomy:
152W00000X - Optometrist
Is Primary:
Yes

Contacts:

Fax:
2087823436

Filing

Filing Name Filing Number Filing date
Annual Report 0005849939 2024-08-06
Annual Report 0005438322 2023-10-11
Annual Report 0004887680 2022-09-07
Statement of Change of Business Mailing Address 0004737178 2022-05-06
Annual Report 0004332384 2021-07-05

USAspending Awards / Financial Assistance

Date:
2020-04-09
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:
32900.00
Total Face Value Of Loan:
32900.00

Paycheck Protection Program

Date Approved:
2020-04-09
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
32900
Current Approval Amount:
32900
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
33193.85

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Date of last update: 30 May 2025

Sources: Idaho Secretary of State