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  5. PHYSICIANS CLINIC, PLLC

PHYSICIANS CLINIC, PLLC

Company Details

Name: PHYSICIANS CLINIC, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 28 Jan 2000 (25 years ago)
Financial Date End: 31 Jan 2021
Date dissolved: 08 Apr 2021
Entity Number: 47266
Place of Formation: IDAHO
File Number: 47266
ZIP code: 83713
County: Ada County
Principal Address: 4750 N FIVE MILE RD BOISE, ID 83713
Mailing Address: 5750 W STERLING LN BOISE, ID 83703-3000

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PHYSICIANS CLINIC, PLLC 401(K) PLAN 2019 820519050 2020-04-27 PHYSICIANS CLINIC, PLLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2083750500
Plan sponsor’s address 300 E WOODLANDER DR, EAGLE, ID, 83616

Signature of
Role Plan administrator
Date 2020-04-27
Name of individual signing TERRY M LITTLE
Valid signature Filed with authorized/valid electronic signature
PHYSICIANS CLINIC, PLLC 401(K) PLAN 2018 820519050 2020-04-25 PHYSICIANS CLINIC, PLLC 16
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2083750500
Plan sponsor’s address 300 E WOODLANDER DR, EAGLE, ID, 83616

Signature of
Role Plan administrator
Date 2020-04-25
Name of individual signing TERRY M LITTLE
Valid signature Filed with authorized/valid electronic signature
PHYSICIANS CLINIC, PLLC 401(K) PLAN 2018 820519050 2019-06-26 PHYSICIANS CLINIC, PLLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2083750500
Plan sponsor’s address 300 E WOODLANDER DR, EAGLE, ID, 83616

Signature of
Role Plan administrator
Date 2019-06-26
Name of individual signing TERRY M LITTLE
Valid signature Filed with authorized/valid electronic signature
PHYSICIANS CLINIC, PLLC 401(K) PLAN 2017 820519050 2018-07-17 PHYSICIANS CLINIC, PLLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2083750500
Plan sponsor’s address 300 E WOODLANDER DR, EAGLE, ID, 83616

Signature of
Role Plan administrator
Date 2018-07-17
Name of individual signing TERRY M LITTLE
Valid signature Filed with authorized/valid electronic signature
PHYSICIANS CLINIC, PLLC 401(K) PLAN 2016 820519050 2017-07-18 PHYSICIANS CLINIC, PLLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2083750500
Plan sponsor’s address 300 E WOODLANDER DR, EAGLE, ID, 83616

Signature of
Role Plan administrator
Date 2017-07-18
Name of individual signing TERRY M LITTLE
Valid signature Filed with authorized/valid electronic signature
PHYSICIANS CLINIC, PLLC 401(K) PLAN 2015 820519050 2016-09-01 PHYSICIANS CLINIC, PLLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2083750500
Plan sponsor’s address 300 E WOODLANDER DR, EAGLE, ID, 83616

Signature of
Role Plan administrator
Date 2016-09-01
Name of individual signing TERRY M LITTLE
Valid signature Filed with authorized/valid electronic signature
PHYSICIANS CLINIC, PLLC 401(K) PLAN 2014 820519050 2015-07-15 PHYSICIANS CLINIC, PLLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2083750500
Plan sponsor’s address 300 E WOODLANDER DR, EAGLE, ID, 83616

Signature of
Role Plan administrator
Date 2015-07-15
Name of individual signing TERRY M LITTLE
Valid signature Filed with authorized/valid electronic signature
MC MILLAN MEDICAL CENTER 401(K) PLAN 2012 820519050 2013-06-27 PHYSICIANS CLINIC PLLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2089382629
Plan sponsor’s address 300 E WOODLANDER DR, EAGLE, ID, 83616

Signature of
Role Plan administrator
Date 2013-06-27
Name of individual signing TERRY M. LITTLE
Valid signature Filed with authorized/valid electronic signature
MC MILLAN MEDICAL CENTER 401(K) PLAN 2011 820519050 2012-08-10 PHYSICIANS CLINIC PLLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2089382629
Plan sponsor’s address 300 E WOODLANDER DR, EAGLE, ID, 83616

Plan administrator’s name and address
Administrator’s EIN 820519050
Plan administrator’s name PHYSICIANS CLINIC PLLC
Plan administrator’s address 300 E WOODLANDER DR, EAGLE, ID, 83616
Administrator’s telephone number 2089382629

Signature of
Role Plan administrator
Date 2012-08-10
Name of individual signing TERRY M. LITTLE
Valid signature Filed with authorized/valid electronic signature
MC MILLAN MEDICAL CENTER 401(K) PLAN 2010 820519050 2011-07-19 PHYSICIANS CLINIC PLLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2089382629
Plan sponsor’s address 300 E WOODLANDER DR, EAGLE, ID, 83616

Plan administrator’s name and address
Administrator’s EIN 820519050
Plan administrator’s name PHYSICIANS CLINIC PLLC
Plan administrator’s address 300 E WOODLANDER DR, EAGLE, ID, 83616
Administrator’s telephone number 2089382629

Signature of
Role Plan administrator
Date 2011-07-19
Name of individual signing TERRY M. LITTLE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
DR TERRY LITTLE Agent 5750 W. STERLING LN., BOISE, ID 83703

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0004239591 2021-04-08
Annual Report 0003745226 2020-01-13
Statement of Change of Business Mailing Address 0003482766 2019-04-18
Annual Report 0003418854 2019-01-31
Annual Report 0001106585 2017-12-05
Annual Report 0001106584 2016-12-02
Annual Report 0001106583 2015-11-24
Annual Report 0001106582 2014-11-17
Annual Report 0001106581 2013-12-13
Annual Report 0001106580 2012-12-22

Related by officers

No related officers

Related by address

4750 N FIVE MILE RD BOISE, ID 83713

TREASURE VALLEY MEDICAL CLINICS, LLC STATE STREET IMEDIATE MEDICAL CARE CENTER STATE STREET MEDICAL CENTER MCMILLAN MEDICAL CENTER USTICK MEDICAL

5750 W STERLING LN BOISE, ID 83703-3000

TREASURE VALLEY MEDICAL CLINICS, LLC

Date of last update: 28 Nov 2024

Sources: Idaho Secretary of State

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