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SOUTHERN IDAHO PAIN INSTITUTE, P.C.

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Company Details

Name: SOUTHERN IDAHO PAIN INSTITUTE, P.C.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 29 Nov 1996 (29 years ago)
Financial Date End: 30 Nov 2025
Entity Number: 360429
Place of Formation: IDAHO
File Number: 360429
ZIP code: 83301
County: Twin Falls County
Mailing Address: 248 WOODRIDGE DR TWIN FALLS, ID 83301

Agent

Name Role Address
JULIA POLLOW Agent 1150 EASTLAND DR. NORTH, TWIN FALLS, ID 83301

President

Name Role Address Appointed On
Clinton L Dille President 176 FALLS AVE, TWIN FALLS, ID 83301 2020-12-02

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
DLRAHKM6N719
CAGE Code:
99HR2
UEI Expiration Date:
2023-03-25

Business Information

Division Name:
SOUTHERN IDAHO PAIN INSTITUTE PC
Division Number:
SOUTHERN I
Activation Date:
2022-03-02
Initial Registration Date:
2021-10-14

National Provider Identifier

NPI Number:
1932381522

Authorized Person:

Name:
CLINTON L. DILLE
Role:
M.D./ANESTHESIOLOGIST
Phone:

Taxonomy:

Selected Taxonomy:
174400000X - Specialist
Is Primary:
Yes

Contacts:

Fax:
2087333168

Filing

Filing Name Filing Number Filing date
Annual Report 0005962920 2024-11-04
Annual Report 0005491090 2023-11-30
Annual Report 0004987317 2022-11-08
Annual Report 0004444267 2021-10-12
Annual Report 0004081711 2020-12-02

USAspending Awards / Financial Assistance

Date:
2020-04-14
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
213500.00
Total Face Value Of Loan:
213500.00
Date:
2020-04-14
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
-213500.00
Total Face Value Of Loan:
0.00
Date:
2012-07-18
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO ASSIST SMALL BUSINESS CONCERNS BY PROVIDING LONG TERM FINANCING THROUGH THE SALE OF DEBENTURES TO THE PRIVATE SECTOR
Obligated Amount:
0.00
Face Value Of Loan:
-392000.00
Total Face Value Of Loan:
414000.00

Paycheck Protection Program

Date Approved:
2020-04-14
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
213500
Current Approval Amount:
213500
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
216243.33

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Date of last update: 03 Jun 2025

Sources: Idaho Secretary of State