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Innovative Medical Imaging, PLLC

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Company Details

Name: Innovative Medical Imaging, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 09 Jul 2020 (5 years ago)
Financial Date End: 31 Jul 2025
Entity Number: 3936105
Place of Formation: IDAHO
File Number: 716793
ZIP code: 83328
County: Twin Falls County
Principal Address: 4121 N 2600 E FILER, ID 83328
Mailing Address: 4121 N 2600 E FILER, ID 83328-5155

Agent

Name Role Address
Cameron Evans Agent 4121 N 2600 E, FILER, ID 83328

Member

Name Role Address Appointed On
Cameron Evans Member 4121 N 2600 E, FILER, ID 83328 2021-06-08

National Provider Identifier

NPI Number:
1962015776
Certification Date:
2024-02-12

Authorized Person:

Name:
STEPHAN G THIEDE
Role:
AUTHORIZED OFFICIAL
Phone:

Taxonomy:

Selected Taxonomy:
2085R0202X - Diagnostic Radiology Physician
Is Primary:
Yes

Contacts:

Fax:
2087355556

Form 5500 Series

Employer Identification Number (EIN):
851907859
Plan Year:
2023
Number Of Participants:
22
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
13
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0005840866 2024-08-05
Annual Report 0005295972 2023-06-29
Annual Report 0004806603 2022-07-06
Annual Report 0004309491 2021-06-08
Initial Filing 0003936105 2020-07-09

USAspending Awards / Financial Assistance

Date:
2021-08-30
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES WHICH ARE UNABLE TO OBTAIN FINANCING IN THE PRIVATE CREDIT MARKETPLACE
Obligated Amount:
0.00
Face Value Of Loan:
100000.00
Total Face Value Of Loan:
100000.00

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Date of last update: 18 May 2025

Sources: Idaho Secretary of State