0001655393-22-000002.txt : 20220617
0001655393-22-000002.hdr.sgml : 20220617
20220616204637
ACCESSION NUMBER: 0001655393-22-000002
CONFORMED SUBMISSION TYPE: D
PUBLIC DOCUMENT COUNT: 1
ITEM INFORMATION: 06b
FILED AS OF DATE: 20220617
DATE AS OF CHANGE: 20220616
EFFECTIVENESS DATE: 20220617
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: Pinnacle Integrated Medicine, Inc.
CENTRAL INDEX KEY: 0001655393
IRS NUMBER: 474933829
STATE OF INCORPORATION: ID
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: D
SEC ACT: 1933 Act
SEC FILE NUMBER: 021-449514
FILM NUMBER: 221022189
BUSINESS ADDRESS:
STREET 1: P.O. BOX 2008
CITY: BOISE
STATE: ID
ZIP: 83701
BUSINESS PHONE: 208-559-1301
MAIL ADDRESS:
STREET 1: P.O. BOX 2008
CITY: BOISE
STATE: ID
ZIP: 83701
D
1
primary_doc.xml
X0708
D
LIVE
0001655393
Pinnacle Integrated Medicine, Inc.
910 WEST MAIN STREET
STE 230
BOISE
ID
IDAHO
83701
855-939-8482
IDAHO
None
None
Corporation
true
Jason
Haugen
PO Box 2008
Boise
ID
IDAHO
83701
Executive Officer
Director
Board Chair/President
Thad
Woodard
PO Box 2008
Boise
ID
IDAHO
83701
Executive Officer
Director
Chief Medical Officer
Thomas
Wiggins
PO Box 2008
Boise
ID
IDAHO
83701
Executive Officer
Chief Technology Officer
Craig
Hinkle
PO Box 2008
Boise
ID
IDAHO
83701
Director
Mikael
Lagwinski
PO Box 2008
Boise
ID
IDAHO
83701
Director
Julie
Robinson
PO Box 2008
Boise
ID
IDAHO
83701
Director
Wade
Erickson
PO Box 2008
Boise
ID
IDAHO
83701
Director
Leigh
Ann
Woodard
PO Box 2008
Boise
ID
IDAHO
83701
Executive Officer
Director
Quality Director
Cynthia
Alkire
PO Box 2008
Boise
ID
IDAHO
83701
Executive Officer
Director
Care Management Director
Suzanne
McKinney
PO Box 2008
Boise
ID
IDAHO
83701
Executive Officer
Director
Secretary
Dennis
Spencer
PO Box 2008
Boise
ID
IDAHO
83701
Director
Other Health Care
Decline to Disclose
- 06b
false
2022-05-06
true
true
false
0
1992187
998250
993937
false
1
0
0
0
true
false
Pinnacle Integrated Medicine, Inc.
/David Arkoosh/
David Arkoosh
Attorney
2022-06-16