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ROCK CREEK ANESTHESIA SERVICES, PLLC

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Company Details

Name: ROCK CREEK ANESTHESIA SERVICES, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 25 Jan 2018 (7 years ago)
Financial Date End: 31 Jan 2026
Entity Number: 590351
Place of Formation: IDAHO
File Number: 590351
ZIP code: 83341
County: Twin Falls County
Principal Address: 3075 N 3422 E KIMBERLY, ID 83341
Mailing Address: THAD HOLLIST 3849A N 3700 E HANSEN, ID 83334-5039

Agent

Name Role Address
Gregory Edgar Agent 1411 FALLS AVE E, 1201, TWIN FALLS, ID 83301

Member

Name Role Address Appointed On Resigned On
Mark Noorlander Member 1180 PAHSIMEROI DRIVE, TWIN FALLS, ID 83301 2021-07-08 2022-04-19
Mark Noorlander Member 1180 PAHSIMEROI DR, TWIN FALLS, ID 83301 2024-01-03 2024-01-03
Justin Snedaker Member 386 EAGLE WAY, DECLO, ID 83323 2024-01-03 2024-01-03

Manager

Name Role Address Appointed On Resigned On
RUSSELL ROGERS Manager 3075 N 3422 E, KIMBERLY, ID 83341 2021-03-25 2021-07-08
Thad Hollist Manager 3849A N 3700 E, HANSEN, ID 83334 2022-04-19 No data

National Provider Identifier

NPI Number:
1790284198
Certification Date:
2024-08-13

Authorized Person:

Name:
THAD HOLLIST
Role:
MANAGING MEMBER
Phone:

Taxonomy:

Selected Taxonomy:
207L00000X - Anesthesiology Physician
Is Primary:
Yes

Contacts:

Fax:
2087339463

Filing

Filing Name Filing Number Filing date
Annual Report 0006047602 2025-01-03
Annual Report 0005539796 2024-01-03
Annual Report 0005118482 2023-02-16
Dissolution/Revocation - Administrative 0004702652 2022-04-19
Application for Reinstatement 0004705066 2022-04-19

USAspending Awards / Financial Assistance

Date:
2020-04-23
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
1000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-16
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:
20800.00
Total Face Value Of Loan:
20800.00

Paycheck Protection Program

Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
20800
Current Approval Amount:
20800
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
21014.27

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Date of last update: 15 May 2025

Sources: Idaho Secretary of State