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PAIN CARE CLINIC OF IDAHO, P.C.

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Company Details

Name: PAIN CARE CLINIC OF IDAHO, P.C.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 10 Oct 2014 (11 years ago)
Financial Date End: 31 Oct 2025
Entity Number: 614104
Place of Formation: IDAHO
File Number: 614104
ZIP code: 83616
County: Ada County
Mailing Address: STE 150 742 E STATE ST EAGLE, ID 83616-7723

Agent

Name Role Address
EDMUND C BOESE Agent 742 E STATE ST STE 150, EAGLE, ID 83616

Director

Name Role Address Appointed On Resigned On
Edmund Boese Director 742 E. STATE STREET, EAGLE, ID 83616 2020-10-05 No data
Deborah Boese-Dellai Director 742 E STATE STREET, EAGLE, ID 83616 2023-10-03 2023-10-03

National Provider Identifier

NPI Number:
1982093357

Authorized Person:

Name:
EDMUND C BOESE
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QP3300X - Pain Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2089393754

Filing

Filing Name Filing Number Filing date
Annual Report 0005928801 2024-10-04
Annual Report 0005419692 2023-10-03
Annual Report 0004938777 2022-10-05
Annual Report 0004419274 2021-09-14
Annual Report 0004023794 2020-10-05

Paycheck Protection Program

Jobs Reported:
5
Initial Approval Amount:
$21,172
Date Approved:
2020-04-30
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$21,172
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$21,362.55
Servicing Lender:
BMO Bank National Association
Use of Proceeds:
Payroll: $21,172
Jobs Reported:
3
Initial Approval Amount:
$20,042
Date Approved:
2021-02-17
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$20,042
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$20,119.94
Servicing Lender:
BMO Bank National Association
Use of Proceeds:
Payroll: $20,040

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Date of last update: 05 Jul 2025

Sources: Idaho Secretary of State