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  5. Pawtuxet Valley Prescription & Surgical Center, Inc.

Pawtuxet Valley Prescription & Surgical Center, Inc.

Company Details

Name: Pawtuxet Valley Prescription & Surgical Center, Inc.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Revoked Entity
Date of Organization in Rhode Island: 28 Apr 1980 (45 years ago)
Date of Dissolution: 09 Nov 2010 (14 years ago)
Date of Status Change: 09 Nov 2010 (14 years ago)
Identification Number: 000016015
ZIP code: 02816
County: Kent County
Principal Address: 85 SANDY BOTTON ROAD, COVENTRY, RI, 02816, USA
Purpose: PHARMACY SALES & SERVICES
Fictitious names: "ApotheCARE" Division of Pawtuxet Valley (trading name, 1983-09-08 - )

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1437282803 2007-03-14 2023-03-07 65 SANDY BOTTOM RD, COVENTRY, RI, 028165863, US 65 SANDY BOTTOM RD, COVENTRY, RI, 028165863, US

Contacts
Phone +1 401-823-9400
Fax 4108220262

Authorized person
Name MARK GILMORE
Role DIRECTOR OF OPERATIONS
Phone 4018210600

Taxonomy
Taxonomy Code 3336L0003X - Long Term Care Pharmacy
License Number PHA00001
State RI
Is Primary Yes

Other Provider Identifiers
Issuer NCPDP
Number 4103406
State RI
Issuer LICENSE #
Number PHA00001
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PAWTUXET VALLEY PRESICRIPTION 401(K) & PROFIT SHARING PLAN 2009 050433715 2010-09-21 PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER, INC. 76
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 423450
Sponsor’s telephone number 4018210600
Plan sponsor’s address 85 SANDY BOTTOM RD, COVENTRY, RI, 02816

Plan administrator’s name and address
Administrator’s EIN 050433715
Plan administrator’s name PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER, INC.
Plan administrator’s address 85 SANDY BOTTOM RD, COVENTRY, RI, 02816
Administrator’s telephone number 4018210600

Signature of
Role Plan administrator
Date 2010-09-21
Name of individual signing FRANK HARRISON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BRUCE A. WOLPERT, ESQ. Agent 10 DORRANCE STREET SUITE 530, PROVIDENCE, RI, 02903, USA

PRESIDENT

Name Role Address
LEO R BLAIS PRESIDENT 85 SANDY BOTTOM ROAD COVENTRY, RI 02816 USA

Filings

Number Name File Date
201071988460 Revocation Certificate For Failure to File the Annual Report for the Year 2010-11-09
201063041120 Revocation Notice For Failure to File An Annual Report 2010-06-16
200942970340 Annual Report 2009-02-23
200834058680 Annual Report 2008-08-20
200812779970 Revocation Notice For Failure to File An Annual Report 2008-08-04

USAspending Awards. Contracts

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
PO AWARD V6508Q9206 2008-09-13 2008-09-13 2008-09-13
Unique Award Key CONT_AWD_V6508Q9206_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title SMALL PURCHASE DATA
Product and Service Codes 6505: DRUGS AND BIOLOGICALS

Recipient Details
Recipient PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER INC
UEI JKJTFAB7WFE4
Legacy DUNS 050950674
Recipient Address 59 SANDY BOTTOM RD, COVENTRY, 028165863, UNITED STATES
PO AWARD V6508Q8715 2008-09-05 2008-09-05 2008-09-05
Unique Award Key CONT_AWD_V6508Q8715_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title SMALL PURCHASE DATA
Product and Service Codes 6505: DRUGS AND BIOLOGICALS

Recipient Details
Recipient PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER INC
UEI JKJTFAB7WFE4
Legacy DUNS 050950674
Recipient Address 59 SANDY BOTTOM RD, COVENTRY, 028165863, UNITED STATES
PO AWARD V6508Q7646 2008-08-20 2008-08-20 2008-08-20
Unique Award Key CONT_AWD_V6508Q7646_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title SMALL PURCHASE DATA
Product and Service Codes 6505: DRUGS AND BIOLOGICALS

Recipient Details
Recipient PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER INC
UEI JKJTFAB7WFE4
Legacy DUNS 050950674
Recipient Address 59 SANDY BOTTOM RD, COVENTRY, 028165863, UNITED STATES
PO AWARD V6508Q7648 2008-08-20 2008-08-30 2008-08-30
Unique Award Key CONT_AWD_V6508Q7648_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title SMALL PURCHASE DATA
Product and Service Codes 6505: DRUGS AND BIOLOGICALS

Recipient Details
Recipient PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER INC
UEI JKJTFAB7WFE4
Legacy DUNS 050950674
Recipient Address 59 SANDY BOTTOM RD, COVENTRY, 028165863, UNITED STATES
PO AWARD V6508Q5990 2008-07-22 2008-07-22 2008-07-22
Unique Award Key CONT_AWD_V6508Q5990_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title AMPHO B 15%, EYE DROPS 10ML
Product and Service Codes 6505: DRUGS AND BIOLOGICALS

Recipient Details
Recipient PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER INC
UEI JKJTFAB7WFE4
Legacy DUNS 050950674
Recipient Address 59 SANDY BOTTOM RD, COVENTRY, 028165863, UNITED STATES
PO AWARD V6508Q5763 2008-07-18 2008-07-28 2008-07-28
Unique Award Key CONT_AWD_V6508Q5763_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title AMPHO B DROPS.10ML
Product and Service Codes 6505: DRUGS AND BIOLOGICALS

Recipient Details
Recipient PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER INC
UEI JKJTFAB7WFE4
Legacy DUNS 050950674
Recipient Address 59 SANDY BOTTOM RD, COVENTRY, 028165863, UNITED STATES
PO AWARD V6508Q4370 2008-06-24 2008-06-24 2008-06-24
Unique Award Key CONT_AWD_V6508Q4370_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title VANCOMYIN 1MG/0.1ML
Product and Service Codes 6505: DRUGS AND BIOLOGICALS

Recipient Details
Recipient PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER INC
UEI JKJTFAB7WFE4
Legacy DUNS 050950674
Recipient Address 59 SANDY BOTTOM RD, COVENTRY, 028165863, UNITED STATES
PO AWARD V650Q88921 2008-03-21 2008-03-21 2008-03-21
Unique Award Key CONT_AWD_V650Q88921_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title TIMOLOL MAL. PRES FREE 0.05%,5ML
Product and Service Codes 6505: DRUGS AND BIOLOGICALS

Recipient Details
Recipient PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER INC
UEI JKJTFAB7WFE4
Legacy DUNS 050950674
Recipient Address 59 SANDY BOTTOM RD, COVENTRY, 028165863, UNITED STATES
PO AWARD V650Q85635 2008-01-22 2008-01-22 2008-01-22
Unique Award Key CONT_AWD_V650Q85635_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title STERILE EYE DROPS-10ML
Product and Service Codes 6505: DRUGS AND BIOLOGICALS

Recipient Details
Recipient PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER INC
UEI JKJTFAB7WFE4
Legacy DUNS 050950674
Recipient Address 59 SANDY BOTTOM RD, COVENTRY, 028165863, UNITED STATES
PO AWARD V650Q85385 2008-01-16 2008-01-16 2008-01-16
Unique Award Key CONT_AWD_V650Q85385_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title VANCO EYE DROPS FOR L4642-12/18
Product and Service Codes 6505: DRUGS AND BIOLOGICALS

Recipient Details
Recipient PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER INC
UEI JKJTFAB7WFE4
Legacy DUNS 050950674
Recipient Address 59 SANDY BOTTOM RD, COVENTRY, 028165863, UNITED STATES
Unique Award Key CONT_AWD_V650Q85386_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title VANCO EYE DROPS FOR L4642
Product and Service Codes 6505: DRUGS AND BIOLOGICALS

Recipient Details
Recipient PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER INC
UEI JKJTFAB7WFE4
Legacy DUNS 050950674
Recipient Address 59 SANDY BOTTOM RD, COVENTRY, 028165863, UNITED STATES
Unique Award Key CONT_AWD_V650Q84990_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title TIMOPTIC 0.5% (PRESERVATIVE FREE)
Product and Service Codes 6505: DRUGS AND BIOLOGICALS

Recipient Details
Recipient PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER INC
UEI JKJTFAB7WFE4
Legacy DUNS 050950674
Recipient Address 59 SANDY BOTTOM RD, COVENTRY, 028165863, UNITED STATES
Unique Award Key CONT_AWD_V650Q82107_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title REFILL FOR EYE DROPS
Product and Service Codes 6505: DRUGS AND BIOLOGICALS

Recipient Details
Recipient PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER INC
UEI JKJTFAB7WFE4
Legacy DUNS 050950674
Recipient Address 59 SANDY BOTTOM RD, COVENTRY, 028165863, UNITED STATES
Unique Award Key CONT_AWD_V650Q82108_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title REFILL FOR EYE DROPS
Product and Service Codes 6505: DRUGS AND BIOLOGICALS

Recipient Details
Recipient PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER INC
UEI JKJTFAB7WFE4
Legacy DUNS 050950674
Recipient Address 59 SANDY BOTTOM RD, COVENTRY, 028165863, UNITED STATES

Related by officers

BRUCE A. WOLPERT, ESQ.

MDLS Enterprises, Inc. Allied Anodizing Co., Inc. Feeney Enterprises, Inc. The Angell Pension Group, Inc. M & G Industries, Inc. M & G INDUSTRIES, INC. CAL.J, INC. Dave's Fresh Marketplace of Greenville, Inc. Dave's Fresh Marketplace of West Shore Road, Inc. FLOCK TEX, INC.

LEO R BLAIS

Moo-Cow Realty, Inc. MORIA, LLC COWS- GO- MOO REALTY INC. ARGONATH, LLC

Related by address

No related companies by address

Date of last update: 06 Apr 2025

Sources: Rhode Island Department of State

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