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IDAHO ENDOSCOPY CENTER, LLC

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Company Details

Name: IDAHO ENDOSCOPY CENTER, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 24 Sep 2009 (16 years ago)
Financial Date End: 30 Sep 2026
Entity Number: 271231
Place of Formation: IDAHO
File Number: 271231
ZIP code: 83704
County: Ada County
Principal Address: 6259 W EMERALD STREET BOISE, ID 83704
Mailing Address: 6259 W EMERALD ST BOISE, ID 83704-8731

Agent

Name Role Address
Meghan T Jankowski Agent 6259 W EMERALD ST, BOISE, ID 83704

Member

Name Role Address Appointed On
Digestive Health Clinic, LLC Member 6259 W EMERALD ST, BOISE, ID 83704 2020-08-12

National Provider Identifier

NPI Number:
1043835713
Certification Date:
2020-07-30

Authorized Person:

Name:
MARK A MALLORY
Role:
MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2084891929
Fax:
9868671601

Filing

Filing Name Filing Number Filing date
Annual Report 0006376560 2025-08-01
Annual Report 0005851938 2024-08-08
Annual Report 0005347964 2023-08-03
Annual Report 0004928027 2022-09-29
Annual Report 0004386524 2021-08-16

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Date of last update: 04 Aug 2025

Sources: Idaho Secretary of State