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REGIONAL PHYSICIAN SERVICES OF IDAHO, P.C.

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Company Details

Name: REGIONAL PHYSICIAN SERVICES OF IDAHO, P.C.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved
Date of registration: 15 Jun 2010 (15 years ago)
Financial Date End: 30 Jun 2025
Date dissolved: 12 Nov 2024
Entity Number: 566554
Place of Formation: IDAHO
File Number: 566554
Mailing Address: STE 220 9201 E MOUNTAIN VIEW RD SCOTTSDALE, AZ 85258-5172

Agent

Name Role Address
CORPORATION SERVICE COMPANY Agent 1305 12TH AVE RD, NAMPA, ID 83686

Director

Name Role Address Appointed On
Thomas R. Young III, M.D. Director 9201 E MOUNTAIN VIEW RD, SCOTTSDALE, AZ 85258-5172 2023-06-14

Treasurer

Name Role Address Appointed On
Thomas R. Young III, M.D. Treasurer 9201 E MOUNTAIN VIEW RD, SCOTTSDALE, AZ 85258-5172 2023-06-14

Secretary

Name Role Address Appointed On
Thomas R. Young III, M.D. Secretary 9201 E MOUNTAIN VIEW RD, SCOTTSDALE, AZ 85258-5172 2023-06-14

President

Name Role Address Appointed On
Thomas R. Young III, M.D. President 9201 E MOUNTAIN VIEW RD, SCOTTSDALE, AZ 85258-5172 2020-06-25

National Provider Identifier

NPI Number:
1417246158
Certification Date:
2019-12-11

Authorized Person:

Name:
VICTORIA ALVAREZ
Role:
DIRECTOR, CREDENTIALING
Phone:

Taxonomy:

Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
8775064560
Fax:
4807187643

Filing

Filing Name Filing Number Filing date
Articles of Dissolution 0005978934 2024-11-12
Annual Report 0005779061 2024-06-12
Annual Report 0005283879 2023-06-14
Annual Report 0004774607 2022-06-07
Registered Agent Name/Address Change (mass change) 0004644345 2022-03-08

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Date of last update: 04 Jul 2025

Sources: Idaho Secretary of State