| Name: | Phoenix Integrative Medicine LLC |
| Jurisdiction: | Alaska |
| Legal type: | Limited Liability Company |
| Status: | Good Standing |
| Date of registration: | 20 Jul 2021 (4 years ago) |
| Entity Number: | 10168917 |
| ZIP code: | 99654 |
| County: | Matanuska Susitna |
| Place of Formation: | ALASKA |
| Address: | 1751 E GARDNER WAY , STE G, WASILLA , AK 99654 |
Line of Business
54 Professional, Scientific and Technical ServicesNAICS
541990 ALL OTHER PROFESSIONAL, SCIENTIFIC, AND TECHNICAL SERVICES| Name | Role |
|---|---|
| Jon Hinman | Member |
| Wendy Palin | Member |
| Jon Hinman | Registered Agent |
| Unique Entity ID | Expiration Date | Physical Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KFVEWJE1MQY4 | 2024-10-02 | 1751 E GARDNER WAY, STE G, WASILLA, AK, 99654, 6564, USA | |||||||||||||||||||||||||||||||||||||||||||
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| URL | www.pimalaska.com |
| Congressional District | 00 |
| State/Country of Incorporation | AK, USA |
| Activation Date | 2023-10-05 |
| Initial Registration Date | 2023-10-03 |
| Entity Start Date | 2021-07-20 |
| Fiscal Year End Close Date | Dec 31 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | JON HINMAN |
| Role | DR. |
| Address | 1751 E. GARDNER WAY, SUITE G, WASILLA, AK, 99654, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | JON HINMAN |
| Role | DR. |
| Address | 1751 E. GARDNER WAY, SUITE G, WASILLA, AK, 99654, USA |
| Past Performance | - |
|---|
| License Number | Type | Status | Issue Date | Date of renewal | Expiration date | Description |
|---|---|---|---|---|---|---|
| 2136400 | Business License | Active | 2021-07-20 | 2022-11-20 | 2024-12-31 | LOB: 62 - Health Care and Social Assistance, NAICS: 621111 - OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS) |
| License Number | Program | Type | Status | Issue Date | Effective Date | Expiration Date |
|---|---|---|---|---|---|---|
| 196364 | Telemedicine Business Registry | Telemedicine Business Registry | Active | 2022-06-03 | 2022-06-03 | - |
| 199382 | Telemedicine Business Registry | Telemedicine Business Registry | Active | 2023-06-15 | 2023-06-15 | - |
Date of last update: 24 Jan 2025
Sources: State of Alaska - Department of Commerce, Community, and Economic Development
