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UPPER VALLEY SURGERY CENTER PLLC

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Company Details

Name: UPPER VALLEY SURGERY CENTER PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 15 Apr 2013 (12 years ago)
Financial Date End: 30 Apr 2026
Entity Number: 380616
Place of Formation: IDAHO
File Number: 380616
ZIP code: 83440
County: Madison County
Principal Address: 256 N 2ND E REXBURG, ID 83440
Mailing Address: 256 N 2ND E REXBURG, ID 83440-1638

Agent

Name Role Address
BARRY J PETERSON Agent 256 N 2ND E, REXBURG, ID 83440

Manager

Name Role Address Appointed On Resigned On
Jay McMaster Manager 256 N 2 E, REXBURG, ID 83440 2021-03-03 No data
Barry Peterson Manager 256 N 2 E, REXBURG, ID 83440 2024-03-20 2024-03-20

National Provider Identifier

NPI Number:
1821420571

Authorized Person:

Name:
DR. JAY R MCMASTER
Role:
PHYSICIAN/OWNER
Phone:

Taxonomy:

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

Contacts:

Fax:
2086569645

Filing

Filing Name Filing Number Filing date
Annual Report 0006141470 2025-03-04
Annual Report 0005655059 2024-03-20
Annual Report 0005135115 2023-03-03
Annual Report 0004636402 2022-03-07
Annual Report 0004188008 2021-03-03

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Date of last update: 03 Jun 2025

Sources: Idaho Secretary of State