Snake River Dermatology, P.A.

Fruitland, ID

Idaho

Registered In

04/13/2004

Incorp. Date

Company Summary

Snake River Dermatology, P.A. in Fruitland, ID lists Brock Andersen of Fruitland, ID and Gerald G Overly Md of Boise, ID

Brock Andersen Registered Agent	2101 N WHITLEY DR, FRUITLAND, ID 83619
Brock Andersen President	5016 SARAH CT, FRUITLAND, ID 83619
Gerald G Overly Md Incorporator	5179 FIFESHIRE, BOISE, ID 83704

2101 N WHITLEY DR BROCK ANDERSEN, FRUITLAND, ID 83619 (Mailing) View Map

Form 5500

2101 N Whitney Drive, Fruitland, Id 83619 (208) 452-5999 EIN:16-1697626 Plan Admin:Brock A Andersen

Year	Plan Name	Participants BOY/EOY	Assets BOY/EOY
2022	Plan NameSNAKE RIVER DERMATOLOGY, P.A., 401(K) PLAN Plan #001 Participants BOY/EOY16 / 20 Assets BOY/EOY$1,161,158 / $1,087,519	2022	SNAKE RIVER DERMATOLOGY, P.A., 401(K) PLAN - Plan #001	16 / 20	$1,161,158 / $1,087,519
2021	Plan NameSNAKE RIVER DERMATOLOGY, P.A., 401(K) PLAN Plan #001 Participants BOY/EOY13 / 16 Assets BOY/EOY$889,587 / $1,161,158	2021	SNAKE RIVER DERMATOLOGY, P.A., 401(K) PLAN - Plan #001	13 / 16	$889,587 / $1,161,158
2020	Plan NameSNAKE RIVER DERMATOLOGY, P.A., 401(K) PLAN Plan #001 Participants BOY/EOY13 / 12 Assets BOY/EOY$643,908 / $889,587	2020	SNAKE RIVER DERMATOLOGY, P.A., 401(K) PLAN - Plan #001	13 / 12	$643,908 / $889,587
2019	Plan NameSNAKE RIVER DERMATOLOGY, P.A., 401(K) PLAN Plan #001 Participants BOY/EOY12 / 13 Assets BOY/EOY$414,422 / $643,908	2019	SNAKE RIVER DERMATOLOGY, P.A., 401(K) PLAN - Plan #001	12 / 13	$414,422 / $643,908

Benefit & Retirement Plans based on Form 5500.

PPP Loans

2101 N Whitley Dr, Fruitland, Id 83619-2132 Industry:Offices of Physicians (except Mental Health Specialists)

Loan Date	Approved	Forgiven	Lender	Jobs
04/12/2020	Approved$187,231 Forgiven$188,775 LenderFirst Interstate Bank Jobs12	04/12/2020	$187,231	$188,775	First Interstate Bank	12

PPP Loans based on Paycheck Protection Program.

Person/City Match:Brock Andersen - Fruitland, ID

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Person/City Match:Gerald G Overly Md - Boise, ID

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City Match:Fruitland, ID

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The following government agencies have contributed data:

Idaho Secretary of State's Office U.S. Department of Labor U.S. Small Business Administration

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