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REXBURG FAMILY MEDICAL CENTER, P.L.L.C.

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Company Details

Name: REXBURG FAMILY MEDICAL CENTER, P.L.L.C.
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 03 Jul 1997 (28 years ago)
Financial Date End: 31 Jul 2026
Entity Number: 25700
Place of Formation: IDAHO
File Number: 25700
ZIP code: 83440
County: Madison County
Principal Address: 552 HARVEST DRIVE REXBURG, ID 83440
Mailing Address: 552 HARVEST DR REXBURG, ID 83440-2289

Agent

Name Role Address
MICHAEL M PACKER M.D. Agent 552 HARVEST DRIVE, REXBURG, ID 83440

Manager

Name Role Address Appointed On
Michael Packer Manager 552 HARVEST DRIVE, REXBURG, ID 83440 2021-06-03

National Provider Identifier

NPI Number:
1285700377

Authorized Person:

Name:
DR. MICHAEL M PACKER
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2083569141

Filing

Filing Name Filing Number Filing date
Annual Report 0006293274 2025-06-03
Annual Report 0005761234 2024-06-04
Annual Report 0005262838 2023-06-03
Annual Report 0004776820 2022-06-09
Annual Report 0004300563 2021-06-03

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Date of last update: 13 Jul 2025

Sources: Idaho Secretary of State