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SHOSHONE COUNTY EMS CORPORATION

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Company Details

Name: SHOSHONE COUNTY EMS CORPORATION
Jurisdiction: Idaho
Legal type: Non-Profit Corporation (D)
Status: Inactive-Dissolved
Date of registration: 18 Nov 2011 (14 years ago)
Financial Date End: 30 Nov 2022
Date dissolved: 07 Oct 2021
Entity Number: 582229
Place of Formation: IDAHO
File Number: 582229
ZIP code: 83837
County: Shoshone County
Mailing Address: 911 BUNKER AVE KELLOGG, ID 83837-2213

Agent

Name Role Address
Dennis M O'Brin Agent 413 CEDAR STREET, WALLACE, ID 83873

President

Name Role Address Appointed On
Tamie Eberhard President 911 BUNKER AVENUE, KELLOGG, ID 83837 2020-10-02

National Provider Identifier

NPI Number:
1548520042

Authorized Person:

Name:
WILLIAM A HOLSTEIN JR.
Role:
CHIEF OFFICER
Phone:

Taxonomy:

Selected Taxonomy:
3416L0300X - Land Ambulance
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0004444054 2021-10-12
Articles of Dissolution 0004441495 2021-10-07
Annual Report 0004016442 2020-10-02
Annual Report 0003633720 2019-10-01
Annual Report 0003331087 2018-10-18

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Date of last update: 15 May 2025

Sources: Idaho Secretary of State