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  5. LASALLE PHARMACY, INC.

LASALLE PHARMACY, INC.

Company Details

Name: LASALLE PHARMACY, INC.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Revoked Entity
Date of Organization in Rhode Island: 28 Oct 1987 (37 years ago)
Date of Dissolution: 26 Oct 2016 (8 years ago)
Date of Status Change: 26 Oct 2016 (8 years ago)
Identification Number: 000009356
ZIP code: 02917
County: Providence County
Principal Address: 17F WATERVIEW DRIVE, SMITHFIELD, RI, 02917, USA
Purpose: THE SALE OF PRESCRIPTION DRUGS , NON- PRESCRIPTION DRUGS AND RELATED GOODS AT RETAIL
Fictitious names: JB PHARMACY (trading name, 2004-08-25 - )

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1396787636 2006-06-12 2020-08-22 113 PUTNAM PIKE, JOHNSTON, RI, 029192047, US 113 PUTNAM PIKE, JOHNSTON, RI, 029192047, US

Contacts
Phone +1 401-232-1194

Authorized person
Name MR. WILLIAM J ROSA
Role PRESIDENT
Phone 4012321194

Taxonomy
Taxonomy Code 183500000X - Pharmacist
License Number 02235
State RI
Is Primary Yes

Other Provider Identifiers
Issuer STATE LICENSE NUMBER
Number PHA00356
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LASALLE PHARMACY, INC. 401(K) PLAN 2015 050433548 2016-08-25 LASALLE PHARMACY, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 446110
Sponsor’s telephone number 4018611994
Plan sponsor’s address 1017 SMITH STREET, PROVIDENCE, RI, 02908
LASALLE PHARMACY, INC. 401(K) PLAN 2014 050433548 2015-08-07 LASALLE PHARMACY, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 446110
Sponsor’s telephone number 4018611994
Plan sponsor’s DBA name D/B/A JB PHARMACY
Plan sponsor’s address 1017 SMITH STREET, PROVIDENCE, RI, 02908

Signature of
Role Plan administrator
Date 2015-08-07
Name of individual signing JOHN CAPUANO JR
Valid signature Filed with authorized/valid electronic signature
LASALLE PHARMACY, INC. 401(K) PLAN 2013 050433548 2014-07-28 LASALLE PHARMACY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 446110
Sponsor’s telephone number 4018611994
Plan sponsor’s DBA name D/B/A JB PHARMACY
Plan sponsor’s address 1017 SMITH STREET, PROVIDENCE, RI, 02908

Signature of
Role Plan administrator
Date 2014-07-28
Name of individual signing JOHN CAPUANO JR
Valid signature Filed with authorized/valid electronic signature
LASALLE PHARMACY, INC. 401(K) PLAN 2012 050433548 2013-08-23 LASALLE PHARMACY, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 446110
Sponsor’s telephone number 4012321194
Plan sponsor’s DBA name D/B/A JB PHARMACY
Plan sponsor’s address 113 PUTMAN PIKE, JOHNSTON, RI, 02919

Signature of
Role Plan administrator
Date 2013-08-23
Name of individual signing JOHN CAPUANO JR
Valid signature Filed with authorized/valid electronic signature
LASALLE PHARMACY, INC. 401(K) PLAN 2011 050433548 2012-10-04 LASALLE PHARMACY, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 446110
Sponsor’s telephone number 4012321194
Plan sponsor’s DBA name D/B/A JB PHARMACY
Plan sponsor’s address 113 PUTMAN PIKE, JOHNSTON, RI, 02919

Plan administrator’s name and address
Administrator’s EIN 050433548
Plan administrator’s name LASALLE PHARMACY, INC.
Plan administrator’s address 113 PUTMAN PIKE, JOHNSTON, RI, 02919
Administrator’s telephone number 4012321194

Signature of
Role Plan administrator
Date 2012-10-04
Name of individual signing JOHN CAPUANO JR
Valid signature Filed with authorized/valid electronic signature
LASALLE PHARMACY, INC. 401(K) PLAN 2010 050433548 2011-07-20 LASALLE PHARMACY, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 446110
Sponsor’s telephone number 4012321194
Plan sponsor’s DBA name D/B/A JB PHARMACY
Plan sponsor’s address 113 PUTMAN PIKE, JOHNSTON, RI, 02919

Plan administrator’s name and address
Administrator’s EIN 050433548
Plan administrator’s name LASALLE PHARMACY, INC.
Plan administrator’s address 113 PUTMAN PIKE, JOHNSTON, RI, 02919
Administrator’s telephone number 4012321194

Signature of
Role Plan administrator
Date 2011-07-20
Name of individual signing JOHN L. CAPUANO, JR.
Valid signature Filed with authorized/valid electronic signature
LASALLE PHARMACY, INC. 401(K) PLAN 2009 050433548 2010-10-08 LASALLE PHARMACY, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 446110
Sponsor’s telephone number 4012321194
Plan sponsor’s DBA name D/B/A JB PHARMACY
Plan sponsor’s address 113 PUTMAN PIKE, JOHNSTON, RI, 02919

Plan administrator’s name and address
Administrator’s EIN 050433548
Plan administrator’s name LASALLE PHARMACY, INC.
Plan administrator’s address 113 PUTMAN PIKE, JOHNSTON, RI, 02919
Administrator’s telephone number 4012321194

Signature of
Role Plan administrator
Date 2010-10-08
Name of individual signing CAROL LIPMAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
PASCO F. LOFFREDO, ESQ Agent 946 PARK AVENUE, CRANSTON, RI, 02910, USA

TREASURER

Name Role Address
PAUL HENRY CAPUANO TREASURER 1 PARDON'S WOOD LANE EAST GREENWICH, RI 02818 USA

SECRETARY

Name Role Address
WILLIAM J ROSA, JR. SECRETARY 34 MEADOWVIEW BOULEVARD NORTH PROVIDENCE, RI 02904 USA

VICE PRESIDENT

Name Role Address
JOHN J. CAPUANO JR. VICE PRESIDENT 6 EAST LAKEVIEW BOULEVARD NORTH PROVIDENCE, RI 02904 USA

PRESIDENT

Name Role Address
WILLIAM J ROSA JR PRESIDENT 34 MEADOWVIEW BOULEVARD NORTH PROVIDENCE, RI 02904 USA

Filings

Number Name File Date
201610988490 Revocation Certificate For Failure to File the Annual Report for the Year 2016-10-26
201601349130 Revocation Notice For Failure to File An Annual Report 2016-07-07
201555907620 Annual Report 2015-02-27
201432794220 Annual Report 2014-01-13
201306854470 Annual Report 2013-01-03
201187333350 Annual Report 2011-12-27
201175758310 Annual Report 2011-02-28
201058970770 Annual Report 2010-02-24
200943873550 Annual Report 2009-03-16
200807475870 Annual Report 2008-02-29

Related by officers

PASCO F. LOFFREDO, ESQ

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Related by address

No related companies by address

Date of last update: 05 Oct 2024

Sources: Rhode Island Department of State

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