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Pine Valley Health LLC

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Company Details

Name: Pine Valley Health LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 28 Apr 2025 (2 months ago)
Financial Date End: 30 Apr 2026
Entity Number: 6222478
Place of Formation: IDAHO
File Number: 990992
ZIP code: 83854
County: Kootenai County
Principal Address: PINE VALLEY HEALTH LLC STE R 784 S. CLEARWATER LOOP POST FALLS, ID 83854
Mailing Address: PINE VALLEY HEALTH LLC STE R 784 S CLEARWATER LOOP POST FALLS, ID 83854-9599

Agent

Name Role Address
REGISTERED AGENTS INC Agent 784 S CLEARWATER LOOP STE R, POST FALLS, ID 83854

National Provider Identifier

NPI Number:
1942098074
Certification Date:
2025-04-29

Authorized Person:

Name:
ARSHABH SARDA
Role:
AUTHORIZED INDIVIDUAL
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
207RA0201X - Allergy & Immunology (Internal Medicine) Physician
Is Primary:
No
Selected Taxonomy:
207RR0500X - Rheumatology Physician
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Initial Filing 0006222478 2025-04-28

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Date of last update: 22 Jun 2025

Sources: Idaho Secretary of State