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PCS Procedure Suite, LLC

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Company Details

Name: PCS Procedure Suite, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 19 Jan 2022 (3 years ago)
Financial Date End: 31 Jan 2026
Entity Number: 4576047
Place of Formation: IDAHO
File Number: 801230
ZIP code: 83201
County: Bannock County
Principal Address: MIKELLE 110 VISTA DR. POCATELLO, ID 83201
Mailing Address: MIKELLE 110 VISTA DR POCATELLO, ID 83201-5824

Agent

Name Role Address
Mikelle K Miera Agent 110 VISTA DR, POCATELLO, ID 83201

Member

Name Role Address Appointed On
Mark L Mansfield MD Member 110 VISTA DR., POCATELLO, ID 83201 2022-12-28

National Provider Identifier

NPI Number:
1659029411
Certification Date:
2023-09-28

Authorized Person:

Name:
MARK L MANSFIELD
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2082340026

Filing

Filing Name Filing Number Filing date
Annual Report 0006081819 2025-01-28
Annual Report 0005601467 2024-02-13
Annual Report 0005039455 2022-12-28
Initial Filing 0004576047 2022-01-19

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Date of last update: 09 Jul 2025

Sources: Idaho Secretary of State