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KOOTENAI URGENT CARE, LLC

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Company Details

Name: KOOTENAI URGENT CARE, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 12 Nov 2009 (16 years ago)
Financial Date End: 30 Nov 2025
Entity Number: 274445
Place of Formation: IDAHO
File Number: 274445
ZIP code: 83814
County: Kootenai County
Principal Address: 700 IRONWOOD DR SUITE 220E COEUR D'ALENE, ID 83814
Mailing Address: LEGAL DEPARTMENT 2003 KOOTENAI HEALTH WAY COEUR D ALENE, ID 83814-6051

Member

Name Role Address Appointed On Resigned On
Kootenai Hospital District Member 2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814 2020-11-12 2023-10-04
Kootenai Health, Inc. Member 2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814 2023-10-04 No data

Agent

Name Role Address
Joel P Hazel Agent 2003 KOOTENAI HEALTH WAY, STE 107, COUER D ALENE, ID 83814

Unique Entity ID

CAGE Code:
62NA1
UEI Expiration Date:
2019-11-26

Business Information

Activation Date:
2018-11-26
Initial Registration Date:
2010-07-16

Commercial and government entity program

CAGE number:
62NA1
Status:
Obsolete
Type:
Non-Manufacturer
CAGE Update Date:
2023-11-27
CAGE Expiration:
2023-11-26

Contact Information

POC:
ERIC KOELSCH

National Provider Identifier

NPI Number:
1801147129

Authorized Person:

Name:
ERIC KOELSCH
Role:
ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0005931783 2024-10-07
Annual Report 0005431143 2023-10-04
Change of Registered Office/Agent/Both (by Entity) 0005032561 2022-12-20
Annual Report 0004976186 2022-11-04
Annual Report 0004492169 2021-11-08

USAspending Awards / Contracts

Procurement Instrument Identifier:
N0016718P0155
Award Or Idv Flag:
AWARD
Award Type:
PURCHASE ORDER
Action Obligation:
5354.00
Base And Exercised Options Value:
5354.00
Base And All Options Value:
5354.00
Awarding Agency Name:
Department of Defense
Performance Start Date:
2018-06-20
Description:
MEDICAL SURVEILLANCE/CERTIFICATION EXAMI
Naics Code:
621498: ALL OTHER OUTPATIENT CARE CENTERS
Product Or Service Code:
Q999: MEDICAL- OTHER
Procurement Instrument Identifier:
N0016717P0173
Award Or Idv Flag:
AWARD
Award Type:
PURCHASE ORDER
Action Obligation:
4718.00
Base And Exercised Options Value:
4718.00
Base And All Options Value:
4718.00
Awarding Agency Name:
Department of Defense
Performance Start Date:
2017-05-17
Description:
IGF::OT::IGF MEDICAL SURVEILLANCE EXAMS SERVICES
Naics Code:
621498: ALL OTHER OUTPATIENT CARE CENTERS
Product Or Service Code:
Q509: MEDICAL- INTERNAL MEDICINE
Procurement Instrument Identifier:
N0016715P0226
Award Or Idv Flag:
AWARD
Award Type:
PURCHASE ORDER
Action Obligation:
3703.00
Base And Exercised Options Value:
3703.00
Base And All Options Value:
3703.00
Awarding Agency Name:
Department of Defense
Performance Start Date:
2015-09-15
Description:
IGF::OT::IGF MEDICAL SURVEILLANCE/CERTIFICATION EXAM
Naics Code:
621498: ALL OTHER OUTPATIENT CARE CENTERS
Product Or Service Code:
Q999: MEDICAL- OTHER

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Date of last update: 18 Jul 2025

Sources: Idaho Secretary of State