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PALOUSE SURGERY CENTER, L.L.C.

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Company Details

Name: PALOUSE SURGERY CENTER, L.L.C.
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 05 Feb 2003 (22 years ago)
Financial Date End: 28 Feb 2026
Entity Number: 81283
Place of Formation: IDAHO
File Number: 81283
ZIP code: 83843
County: Latah County
Principal Address: 2300 W A ST MOSCOW, ID 83843
Mailing Address: 2300 W A ST MOSCOW, ID 83843-4038

Manager

Name Role Address Appointed On Resigned On
ROBERT SMITH Manager 2300 WEST A ST., MOSCOW, ID 83843 2021-01-04 2024-01-03
EDWARD R WINTERBOTTOM Manager 2300 W A STREET, MOSCOW, ID 83843 2024-01-03 No data
AARON VANDENBOS Manager 2300 W A ST, MOSCOW, ID 83843-4038 2024-01-03 No data
KARA BESST Manager 2300 WEST A ST., MOSCOW, ID 83843 2024-01-03 2024-01-03
DAVID LEACH Manager 2300 WEST A ST., MOSCOW, ID 83843 2024-01-03 No data
KYLE HAZELWOOD Manager 2300 W A ST, MOSCOW, ID 83843-4038 2024-01-03 No data
CONNIE OSBORNE Manager 2300 WEST A ST., MOSCOW, ID 83843 2024-01-03 2024-01-03

Agent

Name Role Address
Susie Needham Agent 2300 W A ST, MOSCOW, ID 83843

Central Index Key

CIK number:
0001228584
Phone:
2088832220

Latest Filings

Form type:
REGDEX
File number:
021-54634
Filing date:
2003-04-22
File:

National Provider Identifier

NPI Number:
1750386256
Certification Date:
2024-02-13

Authorized Person:

Name:
MRS. SUSAN NEEDHAM
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2088827701

Filing

Filing Name Filing Number Filing date
Annual Report 0006050127 2025-01-06
Annual Report 0005535318 2024-01-03
Annual Report 0005047272 2023-01-03
Annual Report 0004552232 2022-01-04
Annual Report 0004115171 2021-01-04

Paycheck Protection Program

Jobs Reported:
12
Initial Approval Amount:
$135,400
Date Approved:
2020-04-27
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$135,400
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$136,791.1
Servicing Lender:
Banner Bank
Use of Proceeds:
Payroll: $135,400

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Date of last update: 14 Jul 2025

Sources: Idaho Secretary of State