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ROBERT WILLIAM HAGEN, M.D., INC

Company Details

Name: ROBERT WILLIAM HAGEN, M.D., INC
Jurisdiction: Idaho
Legal type: General Business Corporation (D)
Status: Inactive-Dissolved
Date of registration: 15 Jun 2011 (14 years ago)
Financial Date End: 30 Jun 2016
Date dissolved: 03 Mar 2016
Entity Number: 578030
Place of Formation: IDAHO
File Number: 0000578030
ZIP code: 83833
County: Kootenai County
Mailing Address: 17859 S. HIGHWAY 97 HARRISON, ID 83833

National Provider Identifier

NPI Number:
1316232150

Authorized Person:

Name:
CHARLOTTE MARY HAGEN
Role:
VP
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
452532843
Plan Year:
2016
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
1
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Articles of Dissolution 0000934162 2016-03-03
Annual Report 0003237884 2015-07-15
Annual Report 0003237883 2014-04-28
Annual Report 0003237882 2013-04-30
Annual Report 0003237881 2012-04-16

Date of last update: 26 Sep 2024

Sources: Idaho Secretary of State