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PHS MD #1, LLC

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Company Details

Name: PHS MD #1, LLC
Jurisdiction: Idaho
Legal type: Foreign Limited Liability Company
Status: Active-Existing
Date of registration: 09 Sep 2009 (16 years ago)
Financial Date End: 30 Sep 2025
Entity Number: 270038
Place of Formation: DELAWARE
File Number: 270038
Principal Address: ONE BURTON HILLS BOULEVARD SUITE 250 NASHVILLE, TN 37238
Mailing Address: SUITE 100 340 SEVEN SPRINGS WAY BRENTWOOD, TN 37027

Agent

Name Role Address
CORPORATION SERVICE COMPANY Agent 1305 12TH AVE RD, NAMPA, ID 83686

Member

Name Role Address Appointed On
STEPHEN C. PETROVICH Member ONE BURTON HILLS BOULEVARD, NASHVILLE, TN 37215 2020-08-28

National Provider Identifier

NPI Number:
1124355813

Authorized Person:

Name:
JOHN ABREU
Role:
CFO
Phone:

Taxonomy:

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

Contacts:

Fax:
2082392145

Filing

Filing Name Filing Number Filing date
Annual Report 0005909977 2024-09-24
Annual Report 0005375927 2023-08-31
Annual Report 0004871448 2022-08-29
Registered Agent Name/Address Change (mass change) 0004639199 2022-03-08
Registered Agent Name/Address Change (mass change) 0004464794 2021-10-29

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Date of last update: 31 May 2025

Sources: Idaho Secretary of State