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FAMILY HEALTH ASSOCIATES, P.A.

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Company Details

Name: FAMILY HEALTH ASSOCIATES, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 18 Dec 1996 (29 years ago)
Financial Date End: 31 Dec 2022
Date dissolved: 21 Mar 2023
Entity Number: 360959
Place of Formation: IDAHO
File Number: 360959
ZIP code: 83814
County: Kootenai County
Mailing Address: STE 101 914 W IRONWOOD DR COEUR D ALENE, ID 83814-4927

Agent

Name Role Address
Bradley C Drury Agent 914 IRONWOOD DRIVE SUITE 101, COEUR D ALENE, ID 83814

Vice President

Name Role Address Appointed On
Alyssa L Shaw MD Vice President 914 IRONWOOD DRIVE, COEUR D'ALENE, ID 83814 2020-12-15
Alyssa L Shaw Vice President 914 IRONWOOD DRIVE, COEUR D'ALENE, ID 83814 2022-01-17

National Provider Identifier

NPI Number:
1922029636

Authorized Person:

Name:
DR. BRADLEY C DRURY
Role:
PRESIDENT
Phone:

Taxonomy:

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

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
841381858
Plan Year:
2019
Number Of Participants:
18
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
20
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
20
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
21
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
20
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0005162859 2023-03-21
Annual Report 0004573533 2022-01-17
Annual Report 0004101024 2020-12-15
Annual Report 0003709518 2019-12-14
Annual Report 0003372793 2018-12-16

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Date of last update: 29 Jun 2025

Sources: Idaho Secretary of State