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Milestone Medical LLC

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Company Details

Name: Milestone Medical LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved
Date of registration: 01 Aug 2024 (10 months ago)
Financial Date End: 31 Aug 2025
Date dissolved: 07 Mar 2025
Entity Number: 5834896
Place of Formation: IDAHO
File Number: 948576
ZIP code: 83406
County: Bonneville County
Principal Address: 1497 CURLEW DR AMMON, ID 83406
Mailing Address: PO BOX 1846 IDAHO FALLS, ID 83403-1846

Agent

Name Role Address
Paul D. Ziel Agent 770 S WOODRUFF AVE, IDAHO FALLS, ID 83401

National Provider Identifier

NPI Number:
1366274201
Certification Date:
2024-08-20

Authorized Person:

Name:
JED ROBERTSON
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
No
Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
261QM2500X - Medical Specialty Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2085296631

Filing

Filing Name Filing Number Filing date
Statement of Dissolution 0006147795 2025-03-07
Initial Filing 0005834896 2024-08-01

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Date of last update: 23 May 2025

Sources: Idaho Secretary of State