| Name: | SOUTH COUNTY EYE PHYSICIANS AND SURGEONS, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 20 Oct 1976 (48 years ago) |
| Date of Dissolution: | 24 Dec 2013 (11 years ago) |
| Date of Status Change: | 24 Dec 2013 (11 years ago) |
| Identification Number: | 000012921 |
| ZIP code: | 02874 |
| County: | Washington County |
| Principal Address: | P.O. BOX 103, SAUNDERSTOWN, RI, 02874, USA |
| Purpose: | TO RENDER PROFESSIONAL SERVICES BY PERSONS AUTHORIZED AND LICENSED TO PRACTICE MEDICINE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457306151 | 2006-05-23 | 2010-07-06 | 65 BOSTON NECK ROAD, SOUTH COUNTY EYE PHYSICIANS AND SURGEONS INC, NORTH KINGSTOWN, RI, 028525704, US | 65 BOSTON NECK ROAD, NORTH KINGSTOWN, RI, 028525704, US | |||||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 401-294-4506 |
| Fax | 4012958870 |
Authorized person
| Name | DR. THOMAS J COGHLIN |
| Role | PRESIDENT CEO |
| Phone | 4012944506 |
Taxonomy
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AETNA NON HMO |
| Number | 4425631 |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 324 |
| State | RI |
| Issuer | RAILROAD MEDICARE |
| Number | CE6120 |
| Issuer | MEDICAID |
| Number | SC00221 |
| State | RI |
| Issuer | AETNA HMO |
| Number | 0459676 |
| Issuer | NEIGHBORHOOD HEALTH |
| Number | 1998 |
| Issuer | TRICARE |
| Number | R001038 |
| Name | Role | Address |
|---|---|---|
| A. MAX KOHLENBERG, ESQ. | Agent | EDWARDS WILDMAN PALMER LLP 2800 FINANCIAL PLAZA, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| THOMAS J COGHLIN | PRESIDENT | P.O. BOX 103 SAUNDERSTOWN, RI 02874 USA |
| Number | Name | File Date |
|---|---|---|
| 201332101290 | Articles of Dissolution | 2013-12-24 |
| 201312119020 | Annual Report | 2013-02-19 |
| 201291326660 | Annual Report | 2012-03-22 |
| 201176221020 | Annual Report | 2011-03-04 |
| 201056403270 | Annual Report | 2010-01-14 |
| 200945707510 | Statement of Change of Registered/Resident Agent | 2009-03-12 |
| 200943694380 | Annual Report | 2009-03-06 |
| 200809832770 | Annual Report | 2008-03-18 |
Date of last update: 05 Oct 2024
Sources: Rhode Island Department of State
