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WEST VALLEY MEDICAL CENTER, INC.

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Company Details

Name: WEST VALLEY MEDICAL CENTER, INC.
Jurisdiction: Idaho
Legal type: General Business Corporation (D)
Status: Active-Good Standing
Date of registration: 01 May 1987 (38 years ago)
Financial Date End: 31 May 2026
Entity Number: 261250
Place of Formation: IDAHO
File Number: 261250
Mailing Address: PO BOX 750 NASHVILLE, TN 37202-0750

Agent

Name Role Address
C T CORPORATION SYSTEM Agent 10020 W FAIRVIEW AVE, STE 104, BOISE, ID 83704

President

Name Role Address Appointed On
Samuel N. Hazen President ONE PARK PLAZA, NASHVILLE, TN 37203 2021-05-04

Director

Name Role Address Appointed On Resigned On
Christopher F. Wyatt Director ONE PARK PLAZA, NASHVILLE, TN 37203 2024-05-03 2024-05-03
John M. Franck II Director ONE PARK PLAZA, NASHVILLE, TN 37203 2024-05-03 2024-05-03
Samuel N. Hazen Director ONE PARK PLAZA, NASHVILLE, TN 37203 2024-05-03 2024-05-03

Secretary

Name Role Address Appointed On Resigned On
Natalie H. Cline Secretary ONE PARK PLAZA, NASHVILLE, TN 37203 2024-05-03 2024-05-03

Vice President

Name Role Address Appointed On Resigned On
John M. Franck II Vice President ONE PARK PLAZA, NASHVILLE, TN 37203 2024-05-03 2024-05-03

Treasurer

Name Role Address Appointed On Resigned On
John M Hackett Treasurer ONE PARK PLAZA, NASHVILLE, TN 37203 2024-05-03 2024-05-03

Unique Entity ID

Unique Entity ID:
WYG2RT4BMNT6
UEI Expiration Date:
2025-10-29

Business Information

Doing Business As:
WEST VALLEY MEDICAL CENTER
Division Name:
MOUNTAIN DIVISION
Activation Date:
2024-10-30
Initial Registration Date:
2023-11-07

Central Index Key

CIK number:
0001392828
Phone:
6153449551

Latest Filings

Form type:
15-15D
File number:
333-175791-08
Filing date:
2022-07-15
File:
Form type:
15-15D
File number:
333-201463-54
Filing date:
2022-07-15
File:
Form type:
15-15D
File number:
333-226709-45
Filing date:
2022-07-15
File:
Form type:
424B5
File number:
333-226709-45
Filing date:
2021-06-24
File:
Form type:
POSASR
File number:
333-226709-45
Filing date:
2021-06-21
File:

National Provider Identifier

NPI Number:
1881637122

Authorized Person:

Name:
MRS. KATHY MOORE
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Registered Agent Name/Address Change (mass change) 0006275794 2025-05-27
Annual Report 0006261786 2025-05-21
Annual Report 0005717736 2024-05-03
Annual Report 0005216513 2023-05-02
Registered Agent Name/Address Change (mass change) 0004898138 2022-09-12

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Date of last update: 18 Jul 2025

Sources: Idaho Secretary of State