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MINI-CASSIA SURGICAL

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Company Details

Name: MINI-CASSIA SURGICAL
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 23 Apr 1998 (27 years ago)
Entity Number: 57024
Place of Formation: IDAHO
File Number: 0000057024
ZIP code: 83350
County: Minidoka County
Mailing Address: 1218 9TH STREET #10 RUPERT, ID 83350

National Provider Identifier

NPI Number:
1457656217

Authorized Person:

Name:
DR. DACLYNN SCOTT JOHNSON
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208600000X - Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
2084363956

Filing

Filing Name Filing Number Filing date
Amendment of Certificate of Assumed Business Name 0000670828 2010-12-09
Initial Filing 0000057024 1998-04-23

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Date of last update: 23 Sep 2024

Sources: Idaho Secretary of State