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BOISE OPTIMAL NUTRITION LLC

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Company Details

Name: BOISE OPTIMAL NUTRITION LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved
Date of registration: 21 Feb 2017 (8 years ago)
Financial Date End: 28 Feb 2021
Date dissolved: 29 Mar 2021
Entity Number: 540866
Place of Formation: IDAHO
File Number: 540866
ZIP code: 83714
County: Ada County
Principal Address: 12747 N 11TH AVE BOISE, ID 83714
Mailing Address: MEDINA BLANCHET 12747 N 11TH AVE BOISE, ID 83714-9334

Agent

Name Role Address
MEDINA BLANCHET Agent 12747 N 11TH AVE, BOISE, ID 83714

National Provider Identifier

NPI Number:
1538625827
Certification Date:
2023-09-07

Authorized Person:

Name:
MEDINA E BLANCHET
Role:
MANAGING MEMBER/PROVIDER
Phone:

Taxonomy:

Selected Taxonomy:
133V00000X - Registered Dietitian
Is Primary:
Yes

Contacts:

Fax:
2085018922

Filing

Filing Name Filing Number Filing date
Statement of Dissolution 0004221026 2021-03-29
Annual Report 0003758287 2020-01-30
Annual Report 0003411089 2019-01-24
Annual Report 0003163361 2018-01-09
Initial Filing 0000540866 2017-02-21

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Date of last update: 03 Jul 2025

Sources: Idaho Secretary of State