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River Horse Medical Clinic, PLLC

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Company Details

Name: River Horse Medical Clinic, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 09 Sep 2024 (9 months ago)
Financial Date End: 30 Sep 2025
Entity Number: 5894693
Place of Formation: IDAHO
File Number: 954278
ZIP code: 83823
County: Latah County
Principal Address: 500 2ND AVENUE DEARY, ID 83823
Mailing Address: JENNIFER GRINAGE 1200 NORA CREEK RD TROY, ID 83871-9647

Agent

Name Role Address
REGISTERED AGENTS INC Agent 784 S CLEARWATER LOOP STE R, POST FALLS, ID 83854

National Provider Identifier

NPI Number:
1144057852
Certification Date:
2024-11-14

Authorized Person:

Name:
JENNIFER GRINAGE
Role:
OWNER/CEO
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2086161453

Filing

Filing Name Filing Number Filing date
Initial Filing 0005894693 2024-09-09

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Date of last update: 23 May 2025

Sources: Idaho Secretary of State