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CUSTOM VISION CARE ASSOCIATES PA

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Company Details

Name: CUSTOM VISION CARE ASSOCIATES PA
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 15 Apr 2011 (14 years ago)
Financial Date End: 30 Apr 2016
Date dissolved: 28 Jul 2016
Entity Number: 576244
Place of Formation: IDAHO
File Number: 0000576244
ZIP code: 83686
County: Canyon County
Mailing Address: 1615 12TH AVE RD. STE. B NAMPA, ID 83686

National Provider Identifier

NPI Number:
1013212133

Authorized Person:

Name:
JORGE A MARTINEZ
Role:
PHYSICIAN OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207W00000X - Ophthalmology Physician
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0003234731 2015-02-20
Annual Report 0003234730 2014-03-14
Annual Report 0003234729 2013-03-06
Annual Report 0003234728 2012-05-14
Legacy Amendment 0003234727 2012-02-15

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Date of last update: 26 Sep 2024

Sources: Idaho Secretary of State