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RENCHER FAMILY PRACTICE, P.A.

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Company Details

Name: RENCHER FAMILY PRACTICE, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 17 Jan 2008 (17 years ago)
Financial Date End: 31 Jan 2019
Date dissolved: 15 May 2019
Entity Number: 534991
Place of Formation: IDAHO
File Number: 534991
ZIP code: 83404
County: Bonneville County
Mailing Address: 2610 CHANNING WAY IDAHO FALLS, ID 83404

Agent

Name Role Address
MARK RENCHER Agent 2610 CHANNING WAY, IDAHO FALLS, ID 83404

National Provider Identifier

NPI Number:
1902048879

Authorized Person:

Name:
DR. MARK B RENCHER
Role:
PHYSICIAN
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0003512580 2019-05-15
Annual Report 0003149898 2017-11-27
Annual Report 0003149897 2016-12-02
Annual Report 0003149896 2015-11-28
Annual Report 0003149895 2014-11-17

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Date of last update: 03 Jul 2025

Sources: Idaho Secretary of State