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  5. AQUIDNECK RADIOLOGISTS, INC.

AQUIDNECK RADIOLOGISTS, INC.

Company Details

Name: AQUIDNECK RADIOLOGISTS, INC.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Dissolved
Date of Organization in Rhode Island: 30 Jul 1973 (52 years ago)
Date of Dissolution: 31 Dec 2022 (2 years ago)
Date of Status Change: 31 Dec 2022 (2 years ago)
Identification Number: 000001227
ZIP code: 02840
County: Newport County
Principal Address: 39 LONG WHARF MALL, NEWPORT, RI, 02840, USA
Purpose: RADIOLOGISTS
NAICS: 621111 - Offices of Physicians (except Mental Health Specialists)

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1669579702 2006-09-20 2020-08-22 39 LONG WHARF MALL, NEWPORT, RI, 028402906, US 11 FRIENDSHIP ST, NEWPORT HOSPITAL, NEWPORT, RI, 028402209, US

Contacts
Phone +1 401-845-1338
Fax 4018486008

Authorized person
Name DR. DONALD B. FLETCHER JR.
Role TREASURER
Phone 4018451338

Taxonomy
Taxonomy Code 2085R0202X - Diagnostic Radiology Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 9000120
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AQUIDNECK RADIOLOGISTS, INC. PROFIT SHARING 401(K) PLAN 2022 050352655 2023-10-10 AQUIDNECK RADIOLOGISTS, INC. 5
File View Page
Three-digit plan number (PN) 006
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018454253
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2023-10-10
Name of individual signing JASON VACHON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-10
Name of individual signing JASON VACHON
Valid signature Filed with authorized/valid electronic signature
AQUIDNECK RADIOLOGISTS, INC. PROFIT SHARING 401(K) PLAN 2022 050352655 2023-10-30 AQUIDNECK RADIOLOGISTS, INC. 4
File View Page
Three-digit plan number (PN) 006
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018454253
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2023-10-30
Name of individual signing JASON VACHON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-30
Name of individual signing JASON VACHON
Valid signature Filed with authorized/valid electronic signature
AQUIDNECK RADIOLOGISTS, INC. PROFIT SHARING 401(K) PLAN 2021 050352655 2022-10-13 AQUIDNECK RADIOLOGISTS, INC. 5
File View Page
Three-digit plan number (PN) 006
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2022-10-13
Name of individual signing JASON VACHON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-10-13
Name of individual signing JASON VACHON
Valid signature Filed with authorized/valid electronic signature
AQUIDNECK RADIOLOGISTS, INC. PROFIT SHARING 401(K) PLAN 2020 050352655 2021-10-12 AQUIDNECK RADIOLOGISTS, INC. 6
File View Page
Three-digit plan number (PN) 006
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2021-10-12
Name of individual signing JASON VACHON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-12
Name of individual signing JASON VACHON
Valid signature Filed with authorized/valid electronic signature
AQUIDNECK RADIOLOGISTS, INC. CASH BALANCE PENSION PLAN 2019 050352655 2020-06-27 AQUIDNECK RADIOLOGISTS, INC. 5
File View Page
Three-digit plan number (PN) 007
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2020-06-27
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-06-27
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
AQUIDNECK RADIOLOGISTS, INC. PROFIT SHARING 401(K) PLAN 2019 050352655 2020-09-28 AQUIDNECK RADIOLOGISTS, INC. 6
File View Page
Three-digit plan number (PN) 006
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2020-09-28
Name of individual signing JASON VACHON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-09-28
Name of individual signing JASON VACHON
Valid signature Filed with authorized/valid electronic signature
AQUIDNECK RADIOLOGISTS, INC. CASH BALANCE PENSION PLAN 2018 050352655 2019-06-18 AQUIDNECK RADIOLOGISTS, INC. 5
File View Page
Three-digit plan number (PN) 007
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2019-06-18
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-06-18
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
AQUIDNECK RADIOLOGISTS, INC. PROFIT SHARING 401(K) PLAN 2018 050352655 2019-06-18 AQUIDNECK RADIOLOGISTS, INC. 5
File View Page
Three-digit plan number (PN) 006
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2019-06-18
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-06-18
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
AQUIDNECK RADIOLOGISTS, INC. CASH BALANCE PENSION PLAN 2017 050352655 2018-07-19 AQUIDNECK RADIOLOGISTS, INC. 5
File View Page
Three-digit plan number (PN) 007
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2018-07-19
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-07-19
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
AQUIDNECK RADIOLOGISTS, INC. PROFIT SHARING 401(K) PLAN 2017 050352655 2018-07-19 AQUIDNECK RADIOLOGISTS, INC. 5
File View Page
Three-digit plan number (PN) 006
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2018-07-19
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-07-19
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 006
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2017-05-17
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-17
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/07/19/20180719054859P040073112497001.pdf
Three-digit plan number (PN) 006
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2018-07-19
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-07-19
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/05/17/20170517123924P040034350305001.pdf
Three-digit plan number (PN) 007
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2017-05-17
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-17
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/08/28/20160828135922P040004490925001.pdf
Three-digit plan number (PN) 006
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2016-08-28
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-08-28
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/08/28/20160828135731P040004490765001.pdf
Three-digit plan number (PN) 007
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2016-08-28
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-08-28
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/09/11/20150911105549P040053717319001.pdf
Three-digit plan number (PN) 007
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2015-09-11
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-09-11
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/09/11/20150911105849P040063381697001.pdf
Three-digit plan number (PN) 006
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2015-09-11
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-09-11
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/08/20141008150629P040014273055001.pdf
Three-digit plan number (PN) 006
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2014-10-08
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-08
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/08/20141008145754P030012768767001.pdf
Three-digit plan number (PN) 007
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2014-10-08
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-08
Name of individual signing THEODORE KUTCHER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/05/28/20130528100117P030029222839001.pdf
Three-digit plan number (PN) 007
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2013-05-28
Name of individual signing WILLIAM MARTLAND
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/03/21/20130321105937P040180165233001.pdf
Three-digit plan number (PN) 006
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Signature of
Role Plan administrator
Date 2013-03-21
Name of individual signing WILLIAM MARTLAND
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/01/31/20120131084654P040026850417001.pdf
Three-digit plan number (PN) 004
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Plan administrator’s name and address
Administrator’s EIN 050352655
Plan administrator’s name AQUIDNECK RADIOLOGISTS, INC.
Plan administrator’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906
Administrator’s telephone number 4018466400

Signature of
Role Plan administrator
Date 2012-01-31
Name of individual signing WILLIAM MARTLAND
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/02/22/20120222064615P040039053889001.pdf
Three-digit plan number (PN) 006
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Plan administrator’s name and address
Administrator’s EIN 050352655
Plan administrator’s name AQUIDNECK RADIOLOGISTS, INC.
Plan administrator’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906
Administrator’s telephone number 4018466400

Signature of
Role Plan administrator
Date 2012-02-22
Name of individual signing WILLIAM MARTLAND
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/26/20120726080708P040013897202001.pdf
Three-digit plan number (PN) 007
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Plan administrator’s name and address
Administrator’s EIN 050352655
Plan administrator’s name AQUIDNECK RADIOLOGISTS, INC.
Plan administrator’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906
Administrator’s telephone number 4018466400

Signature of
Role Plan administrator
Date 2012-07-26
Name of individual signing WILLIAM MARTLAND
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/02/08/20110208093234P040001016866001.pdf
Three-digit plan number (PN) 004
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Plan administrator’s name and address
Administrator’s EIN 050352655
Plan administrator’s name AQUIDNECK RADIOLOGISTS, INC.
Plan administrator’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906
Administrator’s telephone number 4018466400

Signature of
Role Plan administrator
Date 2011-02-08
Name of individual signing WILLIAM MARTLAND
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/10/20100710174053P070004246627001.pdf
Three-digit plan number (PN) 004
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 4018466400
Plan sponsor’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906

Plan administrator’s name and address
Administrator’s EIN 050352655
Plan administrator’s name AQUIDNECK RADIOLOGISTS, INC.
Plan administrator’s address 39 LONG WHARF MALL, NEWPORT, RI, 028402906
Administrator’s telephone number 4018466400

Signature of
Role Plan administrator
Date 2010-07-10
Name of individual signing DONALD FLETCHER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BRIAN G. BARDORF, ESQ. Agent 36 WASHINGTON SQUARE, NEWPORT, RI, 02840, USA

PRESIDENT

Name Role Address
JASON VACHON M.D. PRESIDENT 123 ADAMS DRIVE PORTSMOUTH, RI 02871 USA

TREASURER

Name Role Address
SUFALA SAPERS TREASURER 2 WHITTIER ROAD JAMESTOWN, RI 02835 USA

OTHER OFFICER

Name Role
ROBIN SKUNCIK JONES OTHER OFFICER

Filings

Number Name File Date
202225502400 Articles of Dissolution 2022-12-27
202218478840 Annual Report 2022-06-13
202193345360 Annual Report 2021-03-01
202035145570 Annual Report 2020-02-25
201989890330 Annual Report 2019-04-04
201861118970 Annual Report 2018-03-28
201739025180 Annual Report 2017-03-27
201693658990 Annual Report 2016-03-03
201555758600 Annual Report 2015-02-25
201437795060 Annual Report 2014-03-27

Related by officers

BRIAN G. BARDORF, ESQ.

MARVIN GARDENS, LTD. Urology Associates, Inc. James L. Hurst, D.D.S., Ltd. YESTERDAY'S - NEWPORT, INC. George P. Lewis, Jr. M. D., Ltd. Lions Loom of Newport, Inc. NEWPORT COUNCIL FOR INTERNATIONAL VISITORS JAILHOUSE INN, INC. Budek Films and Slides Co. JAMES A. RYAN MANAGEMENT CORP.

ROBIN SKUNCIK JONES

Koziara, O'Reilly and Skuncik, Ltd. THE DOUGLAS FAMILY COMPANY, LLC Skuncik & Associates, Ltd.

Related by address

39 LONG WHARF MALL, NEWPORT, RI, 02840, USA

Koziara, O'Reilly and Skuncik, Ltd. THE DOUGLAS FAMILY COMPANY, LLC Skuncik & Associates, Ltd.

Date of last update: 05 Oct 2024

Sources: Rhode Island Department of State

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