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PEAK MEDICAL OF IDAHO, LLC

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Company Details

Name: PEAK MEDICAL OF IDAHO, LLC
Jurisdiction: Idaho
Legal type: Foreign Limited Liability Company
Status: Inactive-Withdrawn
Date of registration: 28 Apr 2017 (8 years ago)
Financial Date End: 30 Apr 2024
Date dissolved: 06 Jan 2024
Entity Number: 550813
Place of Formation: DELAWARE
File Number: 550813
Principal Address: 101 EAST STATE STREET KENNETT SQUARE, PA 19348
Mailing Address: 101 E STATE ST KENNETT SQUARE, PA 19348-3109

Member

Name Role Address Appointed On
Tim Davis Member 101 EAST STATE STREET, KENNETT SQUARE, PA 19348 2021-03-05
Peak Medical, LLC Member 101 E. STATE STREET, KENNETT SQUARE, PA 19348 2023-03-14

National Provider Identifier

NPI Number:
1841244407

Authorized Person:

Name:
MICHAEL T. BERG
Role:
ASSISTANT SECRETARY
Phone:

Taxonomy:

Selected Taxonomy:
314000000X - Skilled Nursing Facility
Is Primary:
Yes

Contacts:

Fax:
2087340647

Filing

Filing Name Filing Number Filing date
Withdrawal of Foreign Registration Statement 0005545873 2024-01-06
Annual Report 0005155802 2023-03-14
Annual Report 0004676346 2022-03-30
Registered Agent Name/Address Change (mass change) 0004640528 2022-03-08
Registered Agent Name/Address Change (mass change) 0004466103 2021-10-29

USAspending Awards / Contracts

Procurement Instrument Identifier:
36C26021K0044
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
23908.84
Base And Exercised Options Value:
23908.84
Base And All Options Value:
23908.84
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2020-04-01
Description:
EXPRESS REPORT:POP 04/01/2020 TO 4/31/2020
Naics Code:
623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product Or Service Code:
Q402: MEDICAL- NURSING HOME CARE CONTRACTS
Procurement Instrument Identifier:
36C26020K0223
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
110122.31
Base And Exercised Options Value:
110122.31
Base And All Options Value:
110122.31
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2019-10-01
Description:
EXPRESS REPORT: POP 531 TWIN FALLS CARE 10/01/2019 TO 3/31/2020
Naics Code:
623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product Or Service Code:
Q402: MEDICAL- NURSING HOME CARE CONTRACTS
Procurement Instrument Identifier:
36C26019K0031
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
90106.59
Base And Exercised Options Value:
90106.59
Base And All Options Value:
90106.59
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2019-06-01
Description:
EXPRESS REPORT: TWIN FALLS CARE CENTER 06/01/2019 - 09/30/2019
Naics Code:
623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product Or Service Code:
Q402: MEDICAL- NURSING HOME CARE CONTRACTS

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Date of last update: 14 May 2025

Sources: Idaho Secretary of State