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EASTERN IDAHO CARDIOLOGY ASSOCIATES, P.L.L.C.

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Company Details

Name: EASTERN IDAHO CARDIOLOGY ASSOCIATES, P.L.L.C.
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 08 Jun 1998 (27 years ago)
Financial Date End: 30 Jun 2017
Date dissolved: 27 Sep 2017
Entity Number: 34001
Place of Formation: IDAHO
File Number: 0000034001
ZIP code: 83404
County: Bonneville County
Principal Address: 2001 S WOODRUFF AVE STE 12A IDAHO FALLS, ID 83404

National Provider Identifier

NPI Number:
1508866260

Authorized Person:

Name:
DR. PATRICK D GORMAN
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
207RC0000X - Cardiovascular Disease Physician
Is Primary:
Yes

Contacts:

Fax:
2085242256

Form 5500 Series

Employer Identification Number (EIN):
820503860
Plan Year:
2019
Number Of Participants:
1
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
1
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
2
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
13
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Legacy Amendment 0001055197 2017-08-02
Legacy Amendment 0001055196 2017-05-08
Annual Report 0001055194 2016-05-02
Annual Report 0001055192 2015-07-15
Annual Report 0001055190 2014-05-12

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Date of last update: 23 Sep 2024

Sources: Idaho Secretary of State