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  5. SOUTHEAST IDAHO UROLOGY

SOUTHEAST IDAHO UROLOGY

Company Details

Name: SOUTHEAST IDAHO UROLOGY
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 22 Sep 1997 (27 years ago)
Entity Number: 40639
Place of Formation: IDAHO
File Number: 0000040639
ZIP code: 83404
County: Bonneville County
Mailing Address: 2860 CHANNING WAY STE 221 IDAHO FALLS, ID 83404

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTHEAST IDAHO UROLOGY EMPLOYEE RETIREMENT PLAN 2015 841429448 2016-10-11 SOUTHEAST IDAHO UROLOGY 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2085521234
Plan sponsor’s address 8893 SADDLEHORN, IDAHO FALLS, ID, 83404
SOUTHEAST IDAHO UROLOGY EMPLOYEE RETIREMENT PLAN 2014 841429448 2015-08-03 SOUTHEAST IDAHO UROLOGY 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2085521234
Plan sponsor’s address 2330 CORONADO, IDAHO FALLS, ID, 83404
SOUTHEAST IDAHO UROLOGY EMPLOYEE RETIREMENT PLAN 2013 841429448 2014-08-05 SOUTHEAST IDAHO UROLOGY 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2085521234
Plan sponsor’s address 2330 CORONADO, IDAHO FALLS, ID, 83404
SOUTHEAST IDAHO UROLOGY EMPLOYEE RETIREMENT PLAN 2012 841429448 2013-08-15 SOUTHEAST IDAHO UROLOGY 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2085521234
Plan sponsor’s address 2330 CORONADO, IDAHO FALLS, ID, 83404

Signature of
Role Plan administrator
Date 2013-08-15
Name of individual signing TIMOTHY TAYLOR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-08-15
Name of individual signing TIMOTHY TAYLOR
Valid signature Filed with authorized/valid electronic signature
SOUTHEAST IDAHO UROLOGY EMPLOYEE RETIREMENT PLAN 2011 841429448 2012-07-09 SOUTHEAST IDAHO UROLOGY 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2085521234
Plan sponsor’s address 2330 CORONADO, IDAHO FALLS, ID, 83404

Plan administrator’s name and address
Administrator’s EIN 841429448
Plan administrator’s name SOUTHEAST IDAHO UROLOGY
Plan administrator’s address 2330 CORONADO, IDAHO FALLS, ID, 83404
Administrator’s telephone number 2085521234

Signature of
Role Plan administrator
Date 2012-07-09
Name of individual signing TIMOTHY TAYLOR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-09
Name of individual signing TIMOTHY TAYLOR
Valid signature Filed with authorized/valid electronic signature
SOUTHEAST IDAHO UROLOGY EMPLOYEE RETIREMENT PLAN 2010 841429448 2011-04-25 SOUTHEAST IDAHO UROLOGY 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2085521234
Plan sponsor’s address 2330 CORONADO, IDAHO FALLS, ID, 83404

Plan administrator’s name and address
Administrator’s EIN 841429448
Plan administrator’s name SOUTHEAST IDAHO UROLOGY
Plan administrator’s address 2330 CORONADO, IDAHO FALLS, ID, 83404
Administrator’s telephone number 2085521234

Signature of
Role Plan administrator
Date 2011-04-25
Name of individual signing TIMOTHY TAYLOR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-04-25
Name of individual signing TIMOTHY TAYLOR
Valid signature Filed with authorized/valid electronic signature
SOUTHEAST IDAHO UROLOGY EMPLOYEE RETIREMENT PLAN 2009 841429448 2010-07-18 SOUTHEAST IDAHO UROLOGY 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2085521234
Plan sponsor’s address 2330 CORONADO, IDAHO FALLS, ID, 83404

Plan administrator’s name and address
Administrator’s EIN 841429448
Plan administrator’s name SOUTHEAST IDAHO UROLOGY
Plan administrator’s address 2330 CORONADO, IDAHO FALLS, ID, 83404
Administrator’s telephone number 2085521234

Signature of
Role Plan administrator
Date 2010-06-29
Name of individual signing TIMOTHY TAYLOR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-06-29
Name of individual signing TIMOTHY TAYLOR
Valid signature Filed with authorized/valid electronic signature
SOUTHEAST IDAHO UROLOGY EMPLOYEE RETIREMENT PLAN 2009 841429448 2010-06-29 SOUTHEAST IDAHO UROLOGY 6
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2085521234
Plan sponsor’s address 2330 CORONADO, IDAHO FALLS, ID, 83404

Plan administrator’s name and address
Administrator’s EIN 841429448
Plan administrator’s name SOUTHEAST IDAHO UROLOGY
Plan administrator’s address 2330 CORONADO, IDAHO FALLS, ID, 83404
Administrator’s telephone number 2085521234

Signature of
Role Plan administrator
Date 2010-06-29
Name of individual signing TIMOTHY TAYLOR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-06-29
Name of individual signing TIMOTHY TAYLOR
Valid signature Filed with authorized/valid electronic signature

Filing

Filing Name Filing Number Filing date
Initial Filing 0000040639 1997-09-22

Related by officers

No related officers

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Date of last update: 23 Sep 2024

Sources: Idaho Secretary of State

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