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DOCTOR'S CLINIC OF ELMORE COUNTY P.L.L.C.

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Company Details

Name: DOCTOR'S CLINIC OF ELMORE COUNTY P.L.L.C.
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 14 Jul 2000 (25 years ago)
Financial Date End: 31 Jul 2025
Entity Number: 51591
Place of Formation: IDAHO
File Number: 51591
ZIP code: 83647
County: Elmore County
Principal Address: 2000 AMERICAN LEGION BLVD MOUNTAIN HOME, ID 83647
Mailing Address: 2000 AMERICAN LEGION BLVD MOUNTAIN HOME, ID 83647-3138

Agent

Name Role Address
LAYNE D ROBERTS DO Agent 2000 AMERICAN LEGION BLVD, MOUNTAIN HOME, ID 83647

Manager

Name Role Address Appointed On
Layne Roberts Manager 2000 AMERICAN LEGION BLVD, MOUNTAIN HOME, ID 83647-3138 2020-07-07

National Provider Identifier

NPI Number:
1063578664

Authorized Person:

Name:
DR. LAYNE D ROBERTS
Role:
PHYSICIAN
Phone:

Taxonomy:

Selected Taxonomy:
363A00000X - Physician Assistant
Is Primary:
No
Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
2085873180

Form 5500 Series

Employer Identification Number (EIN):
820524441
Plan Year:
2023
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
15
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
15
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
16
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
15
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0005753765 2024-06-03
Annual Report 0005303164 2023-07-05
Annual Report 0004771316 2022-06-06
Annual Report 0004310704 2021-06-09
Annual Report 0003934401 2020-07-07

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Date of last update: 14 Jul 2025

Sources: Idaho Secretary of State