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PARKWAY SURGERY CENTER, LLC

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Company Details

Name: PARKWAY SURGERY CENTER, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 14 Mar 2002 (23 years ago)
Financial Date End: 31 Mar 2022
Date dissolved: 24 Jun 2022
Entity Number: 68944
Place of Formation: IDAHO
File Number: 68944
ZIP code: 83221
County: Bingham County
Principal Address: 1485 PARKWAY BLACKFOOT, ID 83221
Mailing Address: PO BOX 1583 IDAHO FALLS, ID 83403-1583

Agent

Name Role Address
ROBERT J LEE Agent 6073 WEST 49 SOUTH, IDAHO FALLS, ID 83402

Manager

Name Role Address Appointed On
Nanette Brown Manager 2325 CORONADO ST, IDAHO FALLS, ID 83404 2021-02-08

National Provider Identifier

NPI Number:
1013278993

Authorized Person:

Name:
ROBERT J LEE
Role:
CO-MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary:
Yes

Contacts:

Fax:
2087855112

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0004790887 2022-06-24
Annual Report 0004168787 2021-02-08
Annual Report 0003812795 2020-03-13
Annual Report 0003462457 2019-03-26
Annual Report 0001178188 2018-02-09

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Date of last update: 25 May 2025

Sources: Idaho Secretary of State