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ROCKY MOUNTAIN GYN AND HORMONE CENTER

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Company Details

Name: ROCKY MOUNTAIN GYN AND HORMONE CENTER
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 09 Nov 2005 (20 years ago)
Entity Number: 289966
Place of Formation: IDAHO
File Number: 0000289966
ZIP code: 83616
County: Ada County
Mailing Address: PO BOX 757 EAGLE, ID 83616

National Provider Identifier

NPI Number:
1265512818

Authorized Person:

Name:
TAMARA MARIE SIMON
Role:
OWNER PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207VG0400X - Gynecology Physician
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Initial Filing 0000289966 2005-11-09

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Date of last update: 24 Sep 2024

Sources: Idaho Secretary of State