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Paragon Anesthesia LLC

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Company Details

Name: Paragon Anesthesia LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 24 Sep 2024 (9 months ago)
Financial Date End: 30 Sep 2025
Entity Number: 5910241
Place of Formation: IDAHO
File Number: 956526
ZIP code: 83404
County: Bonneville County
Principal Address: 4976 S 11TH E IDAHO FALLS, ID 83404
Mailing Address: 4976 S 11TH E IDAHO FALLS, ID 83404-7693

Agent

Name Role Address
DANIEL PACKARD Agent 1000 RIVERWALK DR, STE 100, IDAHO FALLS, ID 83402

National Provider Identifier

NPI Number:
1831996545
Certification Date:
2025-02-28

Authorized Person:

Name:
JARON POLATIS
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
367500000X - Certified Registered Nurse Anesthetist
Is Primary:
Yes

Contacts:

Fax:
2085238978
Fax:
2087158221

Filing

Filing Name Filing Number Filing date
Initial Filing 0005910241 2024-09-24

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Date of last update: 22 Jun 2025

Sources: Idaho Secretary of State