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BOISE SHOULDER CLINIC, P.A.

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Company Details

Name: BOISE SHOULDER CLINIC, P.A.
Jurisdiction: Idaho
Legal type: General Business Corporation (D)
Status: Active-Good Standing
Date of registration: 19 Sep 2006 (19 years ago)
Financial Date End: 30 Sep 2025
Entity Number: 512185
Place of Formation: IDAHO
File Number: 512185
ZIP code: 83616
County: Ada County
Mailing Address: 3381 W BAVARIA ST EAGLE, ID 83616-5341

Agent

Name Role Address
Carl S Humphrey Agent 1805 W SPANISH BAY DR, EAGLE, ID 83616

President

Name Role Address Appointed On Resigned On
Carl Scott Humphrey President 3381 W BAVARIA ST, EAGLE, ID 83616 2020-08-21 2023-08-03

Secretary

Name Role Address Appointed On
Carrie Humphrey Secretary 1805 W SPANISH BAY DR, EAGLE, ID 83616 2023-08-03

Director

Name Role Address Appointed On
Carl Scott Humphrey Director 1805 W SPANISH BAY DR, EAGLE, ID 83616 2023-08-03

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
JAUCRAG9NU27
CAGE Code:
7GJL9
UEI Expiration Date:
2023-11-28

Business Information

Activation Date:
2022-12-15
Initial Registration Date:
2015-08-28

Filing

Filing Name Filing Number Filing date
Annual Report 0005837469 2024-08-03
Annual Report Amendment 0005579275 2024-02-02
Annual Report 0005343004 2023-08-03
Change of Registered Office/Agent/Both (by Entity) 0004949269 2022-10-11
Annual Report 0004859789 2022-08-12

USAspending Awards / Contracts

Procurement Instrument Identifier:
36C26023P0169
Award Or Idv Flag:
AWARD
Award Type:
PURCHASE ORDER
Action Obligation:
18178.48
Base And Exercised Options Value:
18178.48
Base And All Options Value:
18178.48
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2022-04-04
Description:
RATIFICATION / BOISE SHOULDER CLINIC / ORTHOPEDIC SURGEON
Naics Code:
621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product Or Service Code:
Q513: MEDICAL- ORTHOPEDIC
Procurement Instrument Identifier:
36C26022N0062
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
-49654.33
Base And Exercised Options Value:
-49654.33
Base And All Options Value:
-49654.33
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2021-10-01
Description:
ORTHOPEDIC SHOULDER SURGEON SERVICES
Naics Code:
621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product Or Service Code:
Q513: MEDICAL- ORTHOPEDIC
Procurement Instrument Identifier:
36C26021D0019
Award Or Idv Flag:
IDV
Action Obligation:
0.00
Base And All Options Value:
0.00
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2021-04-01
Description:
ORTHOPEDIC SHOULDER SURGEON SERVICES
Naics Code:
621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product Or Service Code:
Q513: MEDICAL- ORTHOPEDIC

USAspending Awards / Financial Assistance

Date:
2020-04-11
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:
82345.00
Total Face Value Of Loan:
82345.00
Date:
2011-08-05
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO ASSIST SMALL BUSINESS CONCERNS BY PROVIDING LONG TERM FINANCING THROUGH THE SALE OF DEBENTURES TO THE PRIVATE SECTOR
Obligated Amount:
0.00
Face Value Of Loan:
-16000.00
Total Face Value Of Loan:
207000.00

Paycheck Protection Program

Date Approved:
2020-04-11
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
82345
Current Approval Amount:
82345
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
82963.15

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Date of last update: 06 Jun 2025

Sources: Idaho Secretary of State