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Idaho Advanced Medical Care LLC

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Company Details

Name: Idaho Advanced Medical Care LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved
Date of registration: 06 Nov 2021 (4 years ago)
Financial Date End: 30 Nov 2024
Date dissolved: 10 Jun 2024
Entity Number: 4490233
Place of Formation: IDAHO
File Number: 789754
ZIP code: 83713
County: Ada County
Principal Address: 13150 W. PERSIMMON LN. BOISE, ID 83713
Mailing Address: AMY CREAMER 13150 W PERSIMMON LN BOISE, ID 83713-1986

Manager

Name Role Address Appointed On Resigned On
928 Family Limited Partnership Manager 8THE GREEN, DOVER, DE 19901 2023-02-27 No data
David Cooper Manager 13150 W. PERSIMMON LN., BOISE, ID 83713 2023-01-31 2023-02-27

Agent

Name Role Address
Amy Creamer Agent 13150 W PERSIMMON LANE, BOISE, ID 83713

National Provider Identifier

NPI Number:
1487307468
Certification Date:
2022-02-17

Authorized Person:

Name:
DAVID COOPER
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Statement of Dissolution 0005772123 2024-06-10
Annual Report 0005487503 2023-11-27
Amendment to Certificate 0005126272 2023-02-27
Amendment to Certificate 0005098897 2023-02-07
Annual Report 0005086611 2023-01-31

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Date of last update: 20 May 2025

Sources: Idaho Secretary of State