| Name: | MOUNT CARMEL HEALTH PLAN OF IDAHO, INC. |
| Jurisdiction: | Idaho |
| Legal type: | Non-Profit Corporation (D) |
| Status: | Active-Good Standing |
| Date of registration: | 29 Aug 2018 (6 years ago) |
| Financial Date End: | 31 Aug 2025 |
| Entity Number: | 636256 |
| Place of Formation: | IDAHO |
| File Number: | 636256 |
| ZIP code: | 83706 |
| County: | Ada County |
| Mailing Address: | STE 300 1299 ORCHARD ST. BOISE, ID 83706-1248 |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | 1555 W SHORELINE DR, STE 100, BOISE, ID 83702 |
| Name | Role | Address | Appointed On |
|---|---|---|---|
| Lannie Checketts | Director | 1299 ORCHARD ST., BOISE, ID 83706-1248 | 2021-08-03 |
| Jennifer Gudapati | Director | 1070 N CURTIS RD, BOISE, ID 83706-1248 | 2023-07-17 |
| Charles Chodroff MD | Director | 1299 ORCHARD ST., BOISE, ID 83706-1248 | 2024-08-08 |
| Lutana Haan EdD | Director | 1299 ORCHARD ST., BOISE, ID 83706-1248 | 2024-08-08 |
| Name | Role | Address | Appointed On | Resigned On |
|---|---|---|---|---|
| Jack Randolph | President | 1299 ORCHARD ST., BOISE, ID 83706-1248 | 2023-07-17 | No data |
| Cynthia Dellecker | President | 1070 N CURTIS RD, BOISE, ID 83706-1248 | 2020-08-12 | 2021-08-03 |
| Name | Role | Address | Appointed On |
|---|---|---|---|
| David Vis | Treasurer | 1299 ORCHARD ST., BOISE, ID 83706-1248 | 2023-07-17 |
| Filing Name | Filing Number | Filing date |
|---|---|---|
| Annual Report | 0005852084 | 2024-08-08 |
| Annual Report | 0005324898 | 2023-07-17 |
| Registered Agent Name/Address Change (mass change) | 0004900974 | 2022-09-12 |
| Annual Report | 0004889489 | 2022-09-08 |
| Annual Report | 0004364310 | 2021-08-03 |
| Annual Report | 0003970287 | 2020-08-12 |
| Annual Report | 0003655014 | 2019-10-25 |
| Initial Filing | 0000636256 | 2018-08-29 |
Date of last update: 29 Dec 2024
Sources: Idaho Secretary of State
