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Cardiovascular Specialists of America, LLC

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Company Details

Name: Cardiovascular Specialists of America, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 10 Aug 2020 (5 years ago)
Financial Date End: 31 Aug 2025
Entity Number: 3968553
Place of Formation: IDAHO
File Number: 721093
ZIP code: 83201
County: Bannock County
Principal Address: 2431 ANDREW ST POCATELLO, ID 83201-8000

Agent

Name Role Address
LANCE LONGMORE Agent 2431 ANDREW ST, POCATELLO, ID 83201

Member

Name Role Address Appointed On
LANCE LONGMORE Member 2431 ANDREW ST, POCATELLO, ID 83201 2021-07-13

National Provider Identifier

NPI Number:
1871190215
Certification Date:
2020-10-08

Authorized Person:

Name:
LANCE SPENCER LONGMORE
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207RC0001X - Clinical Cardiac Electrophysiology Physician
Is Primary:
Yes

Form 5500 Series

Employer Identification Number (EIN):
852376404
Plan Year:
2023
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
4
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Application for Reinstatement 0005985434 2024-11-15
Dissolution/Revocation - Administrative 0005982248 2024-11-15
Annual Report 0005345350 2023-08-03
Annual Report 0004887855 2022-09-07
Annual Report 0004346029 2021-07-13

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Date of last update: 07 Jul 2025

Sources: Idaho Secretary of State