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MADISON CLINIC OPTOMETRY, P.C.

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Company Details

Name: MADISON CLINIC OPTOMETRY, P.C.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 06 Jul 2004 (21 years ago)
Financial Date End: 31 Jul 2025
Entity Number: 472318
Place of Formation: IDAHO
File Number: 472318
ZIP code: 83440
County: Madison County
Mailing Address: 244 E MAIN ST REXBURG, ID 83440-2022

Agent

Name Role Address
DALLIN HEINER Agent 244 E MAIN, REXBURG, ID 83440

President

Name Role Address Appointed On
Dallin Heiner President 244 E MAIN ST, REXBURG, ID 83440 2021-07-02

National Provider Identifier

NPI Number:
1598876997

Authorized Person:

Name:
DR. DALLIN HEINER
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
152W00000X - Optometrist
Is Primary:
Yes

Contacts:

Fax:
2083592025

Filing

Filing Name Filing Number Filing date
Annual Report 0005759438 2024-06-04
Annual Report 0005276121 2023-06-12
Annual Report 0004765443 2022-06-03
Annual Report 0004329864 2021-07-02
Annual Report 0003889979 2020-06-03

USAspending Awards / Financial Assistance

Date:
2021-01-27
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:
23947.00
Total Face Value Of Loan:
23947.00

Paycheck Protection Program

Date Approved:
2021-01-27
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
23947
Current Approval Amount:
23947
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
24093.31

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Date of last update: 11 May 2025

Sources: Idaho Secretary of State