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Granite Mountain Surgery, PLLC

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Company Details

Name: Granite Mountain Surgery, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 21 Feb 2025 (4 months ago)
Financial Date End: 28 Feb 2026
Entity Number: 6116263
Place of Formation: IDAHO
File Number: 979556
ZIP code: 83704
County: Ada County
Principal Address: DR. AMBER LEE ELLIOTT STE. 195 8950 W. EMERALD STREET BOISE, ID 83704
Mailing Address: DR. AMBER LEE ELLIOTT STE 195 8950 W EMERALD ST BOISE, ID 83704-8296

Agent

Name Role Address
Rosholt Law, PLLC Agent 210 W MURRAY STREET SUITE B, GARDEN CITY, ID 83714

National Provider Identifier

NPI Number:
1477359909
Certification Date:
2025-02-24

Authorized Person:

Name:
AMBER L ELLIOTT
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
208600000X - Surgery Physician
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Notice of Determination 0006203003 2025-04-10
Initial Filing 0006116263 2025-02-21

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Date of last update: 22 Jun 2025

Sources: Idaho Secretary of State