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  5. IDAHO FALLS SURGICAL CENTER

IDAHO FALLS SURGICAL CENTER

Company Details

Name: IDAHO FALLS SURGICAL CENTER
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 30 Dec 2011 (13 years ago)
Entity Number: 462959
Place of Formation: IDAHO
File Number: 0000462959
ZIP code: 83404
County: Bonneville County
Mailing Address: 2325 CORONADO ST IDAHO FALLS, ID 83404

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
IDAHO FALLS SURGICAL CENTER 401(K) PROFIT SHARING PLAN 2011 820358597 2012-09-11 IDAHO FALLS SURGICAL CENTER 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-06-01
Business code 621493
Sponsor’s telephone number 2085245475
Plan sponsor’s address C/O KEITH SCHEUERMANN, 756 S. FOOTHILL RD., IDAHO FALLS, ID, 83401

Plan administrator’s name and address
Administrator’s EIN 820358597
Plan administrator’s name IDAHO FALLS SURGICAL CENTER
Plan administrator’s address C/O KEITH SCHEUERMANN, 756 S. FOOTHILL RD., IDAHO FALLS, ID, 83401
Administrator’s telephone number 2085245475

Signature of
Role Plan administrator
Date 2012-09-11
Name of individual signing KEITH SCHEUERMANN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-09-11
Name of individual signing KEITH SCHEUERMANN
Valid signature Filed with authorized/valid electronic signature
IDAHO FALLS SURGICAL CENTER 401(K) PROFIT SHARING PLAN 2011 820358597 2012-09-10 IDAHO FALLS SURGICAL CENTER 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-06-01
Business code 621493
Sponsor’s telephone number 2085245475
Plan sponsor’s address C/O KEITH SCHEUERMANN, 756 S. FOOTHILL RD., IDAHO FALLS, ID, 83401

Plan administrator’s name and address
Administrator’s EIN 820358597
Plan administrator’s name IDAHO FALLS SURGICAL CENTER
Plan administrator’s address C/O KEITH SCHEUERMANN, 756 S. FOOTHILL RD., IDAHO FALLS, ID, 83401
Administrator’s telephone number 2085245475

Signature of
Role Plan administrator
Date 2012-09-10
Name of individual signing KEITH SCHEUERMANN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-09-10
Name of individual signing KEITH SCHEUERMANN
Valid signature Filed with authorized/valid electronic signature
IDAHO FALLS SURGICAL CENTER 401(K) PROFIT SHARING PLAN 2010 820358597 2011-07-28 IDAHO FALLS SURGICAL CENTER 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-06-01
Business code 621493
Sponsor’s telephone number 2085291945
Plan sponsor’s address 1945 EAST 17TH STREET, IDAHO FALLS, ID, 83404

Plan administrator’s name and address
Administrator’s EIN 820358597
Plan administrator’s name IDAHO FALLS SURGICAL CENTER
Plan administrator’s address 1945 EAST 17TH STREET, IDAHO FALLS, ID, 83404
Administrator’s telephone number 2085291945

Signature of
Role Plan administrator
Date 2011-07-28
Name of individual signing MARK L. PETERSEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-28
Name of individual signing MARK L. PETERSEN
Valid signature Filed with authorized/valid electronic signature
IDAHO FALLS SURGICAL CENTER 401(K) PROFIT SHARING PLAN 2009 820358597 2010-06-25 IDAHO FALLS SURGICAL CENTER 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-06-01
Business code 621493
Sponsor’s telephone number 2085291945
Plan sponsor’s address 1945 EAST 17TH STREET, IDAHO FALLS, ID, 83404

Plan administrator’s name and address
Administrator’s EIN 820358597
Plan administrator’s name IDAHO FALLS SURGICAL CENTER
Plan administrator’s address 1945 EAST 17TH STREET, IDAHO FALLS, ID, 83404
Administrator’s telephone number 2085291945

Signature of
Role Plan administrator
Date 2010-06-25
Name of individual signing MARK L. PETERSEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-06-25
Name of individual signing MARK L. PETERSEN
Valid signature Filed with authorized/valid electronic signature

Filing

Filing Name Filing Number Filing date
Initial Filing 0000462959 2011-12-30

Related by officers

No related officers

Related by address

2325 CORONADO ST IDAHO FALLS, ID 83404

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Date of last update: 26 Sep 2024

Sources: Idaho Secretary of State

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