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MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC

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Company Details

Name: MOUNTAIN RIVER BIRTHING AND SURGERY CENTER, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 25 Nov 2002 (23 years ago)
Financial Date End: 30 Nov 2025
Entity Number: 78106
Place of Formation: IDAHO
File Number: 78106
ZIP code: 83221
County: Bingham County
Principal Address: 98 POPLAR ST BLACKFOOT, ID 83221
Mailing Address: JAKE ERICKSON 350 N MERIDIAN ST BLACKFOOT, ID 83221-1625

Agent

Name Role Address
JAKE ERICKSON Agent 98 POPLAR ST, BLACKFOOT, ID 83221

Manager

Name Role Address Appointed On
Jake Erickson Manager 98 POPLAR ST, BLACKFOOT, ID 83221 2020-12-02

National Provider Identifier

NPI Number:
1851371959
Certification Date:
2019-12-16

Authorized Person:

Name:
JACOB ERICKSON
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
282N00000X - General Acute Care Hospital
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
470917144
Plan Year:
2023
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
7
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0005932910 2024-10-08
Annual Report 0005440392 2023-10-13
Annual Report 0004972614 2022-11-03
Annual Report 0004475300 2021-11-02
Annual Report 0004082414 2020-12-02

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Date of last update: 26 May 2025

Sources: Idaho Secretary of State