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Utah Regional Hospitalists, LLC

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Company Details

Name: Utah Regional Hospitalists, LLC
Jurisdiction: Idaho
Legal type: Foreign Limited Liability Company
Status: Active-Existing
Date of registration: 01 May 2017 (8 years ago)
Financial Date End: 31 May 2026
Entity Number: 631173
Place of Formation: UTAH
File Number: 631173
Principal Address: 4535 DRESSLER RD NW CANTON, OH 44718-2545
Mailing Address: LEGAL DEPARTMENT 4535 DRESSLER RD NW CANTON, OH 44718-2545

Agent

Name Role Address
CORPORATION SERVICE COMPANY Agent 1305 12TH AVE RD, NAMPA, ID 83686

President

Name Role Address Appointed On Resigned On
Stephen Holtzclaw President 900 S. PINE ISLAND RD, 205, PLANTATION, FL 33324 2021-04-01 2023-11-03

Manager

Name Role Address Appointed On
DOMINIC J. BAGNOLI MD JR Manager 4535 DRESSLER ROAD NW, CANTON, OH 44718 2023-11-03

National Provider Identifier

NPI Number:
1740715507
Certification Date:
2023-11-09

Authorized Person:

Name:
MELISSA REESE
Role:
CREDENTIALING AND ENROLLMENT OFFICE
Phone:

Taxonomy:

Selected Taxonomy:
208M00000X - Hospitalist Physician
Is Primary:
Yes

Contacts:

Fax:
3304928489

Filing

Filing Name Filing Number Filing date
Annual Report 0006189686 2025-04-04
Annual Report 0005683209 2024-04-08
Amendment of Foreign Registration with Entity Type Change 0005472684 2023-11-03
Annual Report 0005194405 2023-04-11
Annual Report 0004688461 2022-04-05

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Date of last update: 06 Jul 2025

Sources: Idaho Secretary of State