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TETON RETINAL INSTITUTE, P.A.

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Company Details

Name: TETON RETINAL INSTITUTE, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 04 Nov 1993 (32 years ago)
Financial Date End: 30 Nov 2025
Entity Number: 320985
Place of Formation: IDAHO
File Number: 320985
ZIP code: 83406
County: Bonneville County
Mailing Address: STE 105 3544 E 17TH ST AMMON, ID 83406-6913

Agent

Name Role Address
DARRYL G MOFFETT JR Agent 3544 EAST 17TH STREET, SUITE 105, AMMON, ID 83406

President

Name Role Address Appointed On
Darryl Moffett President 3544 E. 17TH ST, AMMON, ID 83406 2020-11-03

National Provider Identifier

NPI Number:
1437274057

Authorized Person:

Name:
DR. DARRYL G MOFFETT JR.
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207W00000X - Ophthalmology Physician
Is Primary:
Yes

Contacts:

Fax:
2085354906

Form 5500 Series

Employer Identification Number (EIN):
820463316
Plan Year:
2015
Number Of Participants:
13
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
12
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
10
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0005919592 2024-10-03
Annual Report 0005465332 2023-11-06
Annual Report 0004970727 2022-11-03
Annual Report 0004485359 2021-11-04
Annual Report 0004048228 2020-11-03

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Date of last update: 28 Jun 2025

Sources: Idaho Secretary of State