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Surgicare Center of Idaho, L.L.C.

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Company Details

Name: Surgicare Center of Idaho, L.L.C.
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 04 Aug 1999 (26 years ago)
Financial Date End: 31 Aug 2026
Entity Number: 43508
Place of Formation: IDAHO
File Number: 43508
ZIP code: 83706
County: Ada County
Principal Address: STE 125 360 E MALLARD DR BOISE, ID 83706
Mailing Address: STE 125 360 E MALLARD DR BOISE, ID 83706-3941

Agent

Name Role Address
Ryan T Barrett Agent 360 E MALLARD DR, STE 110, BOISE, ID 83706

Member

Name Role Address Appointed On Resigned On
Mark E Hollingshead MD Member 353 N BELLA VIA PL, BOISE, ID 83712 2020-07-21 No data
Ryan T Barrett Member 3481 EAST DARTMOOR COURT, MERIDIAN, ID 83642 2023-09-07 2024-07-15
Mark E Hollingshead Member 353 N BELLA VIA PL, BOISE, ID 83712 2021-09-07 No data

Manager

Name Role Address Appointed On Resigned On
Louis M Pennow Manager 2088 E MEADOWCREEK DR, MERIDIAN, ID 83646 2023-09-07 2024-07-15

National Provider Identifier

NPI Number:
1114923471

Authorized Person:

Name:
MR. LOUIS PENNOW
Role:
DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
261QS0132X - Ophthalmologic Surgery Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2084260902

Filing

Filing Name Filing Number Filing date
Annual Report 0006342008 2025-07-07
Annual Report Amendment 0006041926 2025-01-02
Annual Report 0005820571 2024-07-15
Annual Report 0005388399 2023-09-07
Annual Report 0004805741 2022-07-06

USAspending Awards / Financial Assistance

Date:
2021-04-29
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:
144145.00
Total Face Value Of Loan:
144145.00

Paycheck Protection Program

Jobs Reported:
17
Initial Approval Amount:
$144,145
Date Approved:
2021-04-29
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$144,145
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$145,121.98
Servicing Lender:
Idaho Trust Bank
Use of Proceeds:
Payroll: $144,142
Utilities: $1
Jobs Reported:
11
Initial Approval Amount:
$144,145
Date Approved:
2020-04-10
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$144,145
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$145,033.89
Servicing Lender:
Idaho Trust Bank
Use of Proceeds:
Payroll: $108,108.75
Utilities: $36,036.25

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Date of last update: 14 Jul 2025

Sources: Idaho Secretary of State