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Renew Medical Group of Idaho PC

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Company Details

Name: Renew Medical Group of Idaho PC
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 29 Jan 2025 (7 months ago)
Financial Date End: 31 Jan 2026
Entity Number: 6083149
Place of Formation: IDAHO
File Number: 975204
Mailing Address: 700 E REDLANDS BLVD # U302 REDLANDS, CA 92373-6109

Agent

Name Role Address
NORTHWEST REGISTERED AGENT LLC Agent 784 S CLEARWATER LOOP STE B, POST FALLS, ID 83854

National Provider Identifier

NPI Number:
1881408003
Certification Date:
2025-06-03

Authorized Person:

Name:
DARIN L RENTZ
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
2085R0202X - Diagnostic Radiology Physician
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Initial Filing 0006083149 2025-01-29

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Date of last update: 27 Jul 2025

Sources: Idaho Secretary of State