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BANNOCK INPATIENT SERVICES, PLLC

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Company Details

Name: BANNOCK INPATIENT SERVICES, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved
Date of registration: 17 Nov 2015 (10 years ago)
Financial Date End: 30 Nov 2025
Date dissolved: 30 Apr 2025
Entity Number: 481739
Place of Formation: IDAHO
File Number: 481739
Principal Address: 6363 S. FIDDLERS GREEN CIRCLE SUITE 1400 GREENWOOD VILLAGE, CO 80111
Mailing Address: STE 500 20 BURTON HILLS BLVD NASHVILLE, TN 37215-6187

Agent

Name Role Address
CORPORATION SERVICE COMPANY Agent 1305 12TH AVE RD, NAMPA, ID 83686

Manager

Name Role Address Appointed On Resigned On
MARK JEFFREY SLEPIN, M.D. Manager 1A BURTON HILLS BLVD, NASHVILLE, TN 37215-6187 2021-10-19 2023-11-09
Mark Jeffrey Slepin MD Manager 1A BURTON HILLS BLVD, NASHVILLE, TN 37215-6187 2023-11-09 No data

Member

Name Role Address Appointed On Resigned On
Inpatient Services of Idaho, P.C. Member 7700 W SUNRISE BLVD, PLANTATION, FL 33322-4113 2020-11-25 2021-10-19

National Provider Identifier

NPI Number:
1770948465

Authorized Person:

Name:
MARK J SLEPIN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
207P00000X - Emergency Medicine Physician
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Statement of Dissolution 0006221783 2025-04-26
Annual Report 0005965769 2024-11-05
Annual Report 0005474530 2023-11-09
Annual Report 0004955891 2022-10-18
Registered Agent Name/Address Change (mass change) 0004640174 2022-03-08

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Date of last update: 12 May 2025

Sources: Idaho Secretary of State