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Eagle Rock Medical Center LLC

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Company Details

Name: Eagle Rock Medical Center LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 05 Nov 2021 (4 years ago)
Financial Date End: 30 Nov 2025
Entity Number: 4488611
Place of Formation: IDAHO
File Number: 789711
ZIP code: 83402
County: Bonneville County
Principal Address: 919 SOUTH UTAH AVE IDAHO FALLS, ID 83402
Mailing Address: 919 S UTAH AVE IDAHO FALLS, ID 83402-3322

Agent

Name Role Address
KANO LABS LLC Agent 919 SOUTH UTAH AVE, IDAHO FALLS, ID 83402

Manager

Name Role Address Appointed On
Kendon Howard Manager 919 S UTAH AVE, IDAHO FALLS, ID 83402-3322 2022-11-17

National Provider Identifier

NPI Number:
1083372890
Certification Date:
2022-03-21

Authorized Person:

Name:
KENDON HOWARD
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
873445284
Plan Year:
2023
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
0
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0005957216 2024-11-03
Annual Report 0005416560 2023-10-03
Annual Report 0004996479 2022-11-17
Initial Filing 0004488611 2021-11-05

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Date of last update: 17 Jun 2025

Sources: Idaho Secretary of State