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INTERMOUNTAIN PEDIATRIC CLINIC, P.A.

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Company Details

Name: INTERMOUNTAIN PEDIATRIC CLINIC, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 27 Dec 1990 (34 years ago)
Financial Date End: 31 Dec 2025
Entity Number: 291684
Place of Formation: IDAHO
File Number: 291684
ZIP code: 83704
County: Ada County
Mailing Address: 5211 N SORRENTO DR BOISE, ID 83704-2354

Agent

Name Role Address
GRAVIS LAW, PLLC Agent 1661 W SHORELINE DR, STE 200, BOISE, ID 83702

President

Name Role Address Appointed On
John P Jambura President 5211 N SORRENTO DR, BOISE, ID 83704-2354 2021-12-30
John P Jambura MD President 5211 N SORRENTO DR, BOISE, ID 83704 2020-12-06

Secretary

Name Role Address Appointed On Resigned On
Karen Jambura Secretary 5211 N SORRENTO DR, BOISE, ID 83704-2354 2024-01-16 2024-01-16

Form 5500 Series

Employer Identification Number (EIN):
820441015
Plan Year:
2023
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
4
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0006081079 2025-01-27
Annual Report 0005563054 2024-01-16
Application for Reinstatement 0005222790 2023-05-04
Dissolution/Revocation - Administrative 0005162838 2023-03-21
Annual Report 0004545652 2021-12-30

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Date of last update: 31 May 2025

Sources: Idaho Secretary of State