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ST. MARIES VISION CENTER, PLLC

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Company Details

Name: ST. MARIES VISION CENTER, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 21 Nov 2017 (8 years ago)
Financial Date End: 30 Nov 2025
Date dissolved: 22 Feb 2025
Entity Number: 579181
Place of Formation: IDAHO
File Number: 579181
ZIP code: 83814
County: Kootenai County
Mailing Address: 6598 N CINNAMON CT COEUR D ALENE, ID 83815-8512
Principal Address: 1801 N 3RD ST COEUR D ALENE, ID 83814-3400

Agent

Name Role Address
ROB JOHNSON Agent 6598 CINNAMON CT, COEUR D'ALENE, ID 83815

Manager

Name Role Address Appointed On
Lance Fagan Manager 6160 N 17TH ST, DALTON GARDENS, ID 83815 2023-12-18

Member

Name Role Address Appointed On
Lance Fagan Member 6160 N 17TH ST, DALTON GARDENS, ID 83815 2020-10-03

National Provider Identifier

NPI Number:
1780190694

Authorized Person:

Name:
DR. LANCE WILLIAM FAGAN
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
152W00000X - Optometrist
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Application for Reinstatement 0006128834 2025-02-26
Dissolution/Revocation - Administrative 0006117557 2025-02-22
Annual Report 0005519514 2023-12-18
Annual Report 0005017336 2022-12-07
Annual Report 0004477723 2021-11-03

USAspending Awards / Financial Assistance

Date:
2020-04-07
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
15000.00
Total Face Value Of Loan:
15000.00

Paycheck Protection Program

Date Approved:
2020-04-03
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
15000
Current Approval Amount:
15000
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
15151.23

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Date of last update: 04 Jul 2025

Sources: Idaho Secretary of State