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Premier Medical Associates LLC

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Company Details

Name: Premier Medical Associates LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 02 Oct 2024 (9 months ago)
Financial Date End: 31 Oct 2025
Entity Number: 5917648
Place of Formation: IDAHO
File Number: 957851
ZIP code: 83401
County: Bonneville County
Principal Address: 1846 1ST ST STE 100 #187360 IDAHO FALLS, ID 83401
Mailing Address: STE 100 # 187360 1846 1ST ST IDAHO FALLS, ID 83401-4415

Agent

Name Role Address
UNITED STATES CORPORATION AGENTS INC Agent 800 W MAIN ST STE 1460, BOISE, ID 83702

National Provider Identifier

NPI Number:
1588469621
Certification Date:
2025-02-13

Authorized Person:

Name:
ISAAC DANIEL MOORE
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
2082749125

Filing

Filing Name Filing Number Filing date
Initial Filing 0005917648 2024-10-02

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Date of last update: 22 Jun 2025

Sources: Idaho Secretary of State