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Grand Teton Surgical Center, LLC

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Company Details

Name: Grand Teton Surgical Center, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 29 Oct 1998 (27 years ago)
Financial Date End: 31 Oct 2025
Entity Number: 37659
Place of Formation: IDAHO
File Number: 37659
ZIP code: 83404
County: Bonneville County
Principal Address: 2290 CORONADO ST IDAHO FALLS, ID 83404-7552
Mailing Address: 2325 CORONADO STREET IDAHO FALLS, ID 83404

Agent

Name Role Address
CORPORATION SERVICE COMPANY Agent 1305 12TH AVE RD, NAMPA, ID 83686

Member

Name Role Address Appointed On Resigned On
MOUNTAIN VIEW HOSPITAL, LLC Member 340 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027 2022-10-13 No data
Mountain View Hospital, LLC Member 340 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027 2022-07-07 2022-10-13

National Provider Identifier

NPI Number:
1841295227

Authorized Person:

Name:
TERESA WELLARD
Role:
DIRECTOR OF NURSING
Phone:

Taxonomy:

Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2085243805

Filing

Filing Name Filing Number Filing date
Annual Report 0005909993 2024-09-24
Annual Report 0005431472 2023-10-04
Annual Report 0004952680 2022-10-13
Application for Reinstatement 0004807421 2022-07-07
Dissolution/Revocation - Administrative 0004129843 2021-01-12

USAspending Awards / Financial Assistance

Date:
2020-04-13
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:
198400.00
Total Face Value Of Loan:
198400.00

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Date of last update: 25 May 2025

Sources: Idaho Secretary of State