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ALPINE DERMATOLOGY CLINIC, P.C.

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Company Details

Name: ALPINE DERMATOLOGY CLINIC, P.C.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 03 Dec 2008 (17 years ago)
Financial Date End: 31 Dec 2025
Entity Number: 547491
Place of Formation: IDAHO
File Number: 547491
ZIP code: 83440
County: Madison County
Mailing Address: 1049 SUMMERS DR REXBURG, ID 83440-5335

Agent

Name Role Address
Daniel Marshall Agent 1049 SUMMERS DRIVE, REXBURG, ID 83440

President

Name Role Address Appointed On
Daniel R Marshall President 949 N 12TH W, REXBURG, ID 83440-5015 2021-01-15

Secretary

Name Role Address Appointed On Resigned On
Pauline Marshall Secretary 949 N 12TH W, REXBURG, ID 83440-5015 2023-12-01 2023-12-01

National Provider Identifier

NPI Number:
1588802391

Authorized Person:

Name:
DR. DANIEL R MARSHALL
Role:
OWNER, CEO
Phone:

Taxonomy:

Selected Taxonomy:
261QM2500X - Medical Specialty Clinic/Center
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
263855838
Plan Year:
2023
Number Of Participants:
22
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
29
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
25
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
23
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
23
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0006059679 2025-01-09
Annual Report 0005492020 2023-12-01
Annual Report 0004996585 2022-11-18
Annual Report 0004566702 2022-01-12
Annual Report 0004135662 2021-01-15

USAspending Awards / Financial Assistance

Date:
2020-04-09
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:
285800.00
Total Face Value Of Loan:
285800.00
Date:
2015-07-31
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:
826000.00
Total Face Value Of Loan:
729000.00
Date:
2010-04-16
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES WHICH ARE UNABLE TO OBTAIN FINANCING IN THE PRIVATE CREDIT MARKETPLACE
Obligated Amount:
0.00
Face Value Of Loan:
275000.00
Total Face Value Of Loan:
275000.00

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Date of last update: 08 Jun 2025

Sources: Idaho Secretary of State