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MOUNTAIN HEALTH SERVICES, P.C.

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Company Details

Name: MOUNTAIN HEALTH SERVICES, P.C.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 20 Feb 1996 (29 years ago)
Financial Date End: 28 Feb 2026
Entity Number: 350201
Place of Formation: IDAHO
File Number: 350201
ZIP code: 83837
County: Shoshone County
Mailing Address: 740 MCKINLEY AVE KELLOGG, ID 83837-2693

Agent

Name Role Address
FREDERICK HALLER Agent 740 MCKINLEY AVE, KELLOGG, ID 83837

President

Name Role Address Appointed On
Frederick R Haller President 740 MCKINLEY AVE, KELLOGG, ID 83837 2021-01-04

National Provider Identifier

NPI Number:
1164539912

Authorized Person:

Name:
FREDERICK R HALLER
Role:
MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
2087864471

Form 5500 Series

Employer Identification Number (EIN):
820488009
Plan Year:
2014
Number Of Participants:
20
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
21
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
25
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
23
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
24
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0006090895 2025-02-03
Annual Report 0005581591 2024-02-03
Annual Report 0005057609 2023-01-08
Annual Report 0004595428 2022-02-04
Annual Report 0004114294 2021-01-04

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Date of last update: 20 Jul 2025

Sources: Idaho Secretary of State