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ADDISON SURGERY CENTER, INC.

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Company Details

Name: ADDISON SURGERY CENTER, INC.
Jurisdiction: Idaho
Legal type: General Business Corporation (D)
Status: Active-Good Standing
Date of registration: 30 Aug 1995 (30 years ago)
Financial Date End: 31 Aug 2025
Entity Number: 344485
Place of Formation: IDAHO
File Number: 344485
ZIP code: 83642
County: Ada County
Mailing Address: STE 201 3080 E GENTRY WAY MERIDIAN, ID 83642-3013

Agent

Name Role Address
DAVID A BLACKMER Agent 3080 E GENTRY WAY, SUITE 201, MERIDIAN, ID 83642

President

Name Role Address Appointed On
David Blackmer President 3080 E GENTRY WAY, MERIDIAN, ID 83642 2020-07-03

National Provider Identifier

NPI Number:
1952414609

Authorized Person:

Name:
DAVID A. BLACKMER
Role:
PODIATRIST
Phone:

Taxonomy:

Selected Taxonomy:
261Q00000X - Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2087345993

Filing

Filing Name Filing Number Filing date
Annual Report 0005821074 2024-07-15
Annual Report 0005301986 2023-07-03
Annual Report 0004804043 2022-07-05
Annual Report 0004369833 2021-08-04
Annual Report 0003929158 2020-07-03

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Date of last update: 28 Jun 2025

Sources: Idaho Secretary of State