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EAST IDAHO SURGICAL ASSISTING LLC

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Company Details

Name: EAST IDAHO SURGICAL ASSISTING LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 23 Nov 2015 (10 years ago)
Financial Date End: 30 Nov 2022
Date dissolved: 11 Feb 2023
Entity Number: 482174
Place of Formation: IDAHO
File Number: 482174
ZIP code: 83402
County: Bonneville County
Principal Address: 1435 SCORPIUS DR IDAHO FALLS, ID 83402
Mailing Address: 1435 SCORPIUS DR IDAHO FALLS, ID 83402-1805

Agent

Name Role Address
SAMANTHA MOLBERT Agent 1435 SCORPIUS DR, IDAHO FALLS, ID 83402

Manager

Name Role Address Appointed On
Samantha Molbert Manager 1435 SCORPIUS DR, IDAHO FALLS, ID 83402 2020-10-20

National Provider Identifier

NPI Number:
1205201050

Authorized Person:

Name:
SAMANTHA MOLBERT
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
246ZC0007X - Surgical Assistant
Is Primary:
Yes

Contacts:

Fax:
2147640880

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0005110995 2023-02-11
Annual Report 0004602439 2022-02-09
Annual Report 0004038345 2020-10-20
Application for Reinstatement 0003775362 2020-02-07
Dissolution/Revocation - Administrative 0003773081 2020-02-06

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Date of last update: 02 Jul 2025

Sources: Idaho Secretary of State