| Name: | UNIVERSAL AMBULANCE SERVICE, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 30 Jan 1979 (46 years ago) |
| Date of Dissolution: | 26 Feb 2015 (10 years ago) |
| Date of Status Change: | 26 Feb 2015 (10 years ago) |
| Identification Number: | 000013469 |
| ZIP code: | 02908 |
| County: | Providence County |
| Principal Address: | 457 DOUGLAS AVENUE, PROVIDENCE, RI, 02908, USA |
| Purpose: | FURNISHING AMBULANCE SERVICES AND TRANSPORTATION |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730180357 | 2005-08-04 | 2020-08-22 | 457 DOUGLAS AVE, PROVIDENCE, RI, 029082542, US | 457 DOUGLAS AVE, PROVIDENCE, RI, 029082542, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 401-273-8020 |
| Fax | 4014540763 |
Authorized person
| Name | MR. ALFRED U BARBERY JR. |
| Role | PRESIDENT |
| Phone | 4012738020 |
Taxonomy
| Taxonomy Code | 341600000X - Ambulance |
| License Number | 82 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS |
| Number | 9962 |
| State | RI |
| Issuer | MEDICAID |
| Number | 9009962 |
| State | RI |
| Issuer | BLUE CHIP |
| Number | 003759 |
| State | RI |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| UNIVERSAL AMBULANCE SERVICE, INC. 401(K) | 2014 | 050380472 | 2015-07-27 | UNIVERSAL AMBULANCE SERVICE, INC | 32 | |||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2015-07-27 |
| Name of individual signing | MICHAEL MUTO |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2015-07-27 |
| Name of individual signing | MICHAEL MUTO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1989-01-01 |
| Business code | 621900 |
| Sponsor’s telephone number | 4014619400 |
| Plan sponsor’s address | PO BOX 8981, CRANSTON, RI, 02920 |
Signature of
| Role | Plan administrator |
| Date | 2015-02-11 |
| Name of individual signing | MICHAEL MUTO |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2015-02-11 |
| Name of individual signing | MICHAEL MUTO |
| Valid signature | Filed with incorrect/unrecognized electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1989-01-01 |
| Business code | 621900 |
| Sponsor’s telephone number | 4012738020 |
| Plan sponsor’s address | 480 DOUGLAS AVENUE, PROVIDENCE, RI, 02908 |
Signature of
| Role | Plan administrator |
| Date | 2014-07-09 |
| Name of individual signing | MICHAEL MUTO |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| ORSON AND BRUSINI LTD | Agent | 144 WAYLAND AVENUE, PROVIDENCE, RI, 02906, USA |
| Name | Role | Address |
|---|---|---|
| ALFRED U BARBERY JR | PRESIDENT | 457 DOUGLAS AVENUE PROVIDENCE, RI 02908 USA |
| Number | Name | File Date |
|---|---|---|
| 201555869090 | Articles of Dissolution | 2015-02-26 |
| 201331216850 | Order Appointing Temporary Receiver | 2013-12-03 |
| 201310532560 | Annual Report | 2013-01-29 |
| 201291848810 | Annual Report | 2012-04-12 |
| 201186897880 | Statement of Change of Registered/Resident Agent Office | 2011-12-12 |
| 201175874650 | Annual Report | 2011-02-23 |
| 201059763290 | Annual Report | 2010-02-25 |
| 200951460100 | Statement of Change of Registered/Resident Agent | 2009-09-18 |
| 200940882320 | Annual Report | 2009-01-21 |
| 200808830740 | Annual Report | 2008-02-19 |
Date of last update: 06 Oct 2024
Sources: Rhode Island Department of State
