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  5. OB-GYN Associates, Inc.

OB-GYN Associates, Inc.

Company Details

Name: OB-GYN Associates, Inc.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Dissolved
Date of Organization in Rhode Island: 27 Nov 1970 (54 years ago)
Date of Dissolution: 31 Dec 2016 (8 years ago)
Date of Status Change: 31 Dec 2016 (8 years ago)
Identification Number: 000018713
ZIP code: 02904
County: Providence County
Principal Address: ONE RANDALL SQUARE, PROVIDENCE, RI, 02904, USA
Purpose: PROFESSIONAL SERVICES AS PHYSICIANS AND SURGEONS

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1326140120 2006-09-02 2012-01-05 1 RANDALL SQUARE, STE 205, PROVIDENCE, RI, 02904, US 1 RANDALL SQUARE, STE 205, PROVIDENCE, RI, 02904, US

Contacts
Phone +1 401-331-7178
Fax 4013316181

Authorized person
Name MS. LAURIE SOUSA
Role PRACTICE MANAGER
Phone 4013316980

Taxonomy
Taxonomy Code 207V00000X - Obstetrics & Gynecology Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
OB-GYN ASSOCIATES,INC PROFIT SHARING SAVINGS PLAN 2013 050343024 2014-09-23 OB-GYN ASSOCIATES, INC 33
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1971-02-01
Business code 621111
Sponsor’s telephone number 4013316980
Plan sponsor’s address ONE RANDALL SQUARE, SUITE 205, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2014-09-23
Name of individual signing JOHN J BERT MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-09-23
Name of individual signing JOHN J BERT MD
Valid signature Filed with authorized/valid electronic signature
OB GYN ASSOCIATES,INC PROFIT SHARING SAVINGS PLAN 2013 050343024 2014-07-01 OB GYN ASSOCIATES, INC 71
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1971-02-01
Business code 621111
Sponsor’s telephone number 4013316980
Plan sponsor’s address ONE RANDALL SQUARE, SUITE 205, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2014-06-16
Name of individual signing JOHN J BERT MD
Valid signature Filed with authorized/valid electronic signature
OB GYN ASSOCIATES,INC PROFIT SHARING SAVINGS PLAN 2012 050343024 2013-07-18 OB GYN ASSOCIATES, INC 66
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1971-02-01
Business code 621111
Sponsor’s telephone number 4013316980
Plan sponsor’s address ONE RANDALL SQUARE, SUITE 205, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2013-07-18
Name of individual signing ADRIENNE PERRY, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-18
Name of individual signing ADRIENNE PERRY, MD
Valid signature Filed with authorized/valid electronic signature
OB GYN ASSOCIATES,INC PROFIT SHARING SAVINGS PLAN 2011 050343024 2012-10-13 OB GYN ASSOCIATES, INC 69
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1971-02-01
Business code 621111
Sponsor’s telephone number 4013316980
Plan sponsor’s address ONE RANDALL SQUARE, SUITE 205, PROVIDENCE, RI, 02904

Plan administrator’s name and address
Administrator’s EIN 050343024
Plan administrator’s name OB GYN ASSOCIATES, INC
Plan administrator’s address ONE RANDALL SQUARE, SUITE 205, PROVIDENCE, RI, 02904
Administrator’s telephone number 4013316980

Signature of
Role Plan administrator
Date 2012-10-13
Name of individual signing JOHN BERT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-13
Name of individual signing JOHN BERT
Valid signature Filed with authorized/valid electronic signature
OB GYN ASSOCIATES,INC PROFIT SHARING SAVINGS PLAN 2010 050343024 2011-05-31 OB GYN ASSOCIATES, INC 75
Three-digit plan number (PN) 002
Effective date of plan 1971-02-01
Business code 621111
Sponsor’s telephone number 4013316980
Plan sponsor’s address ONE RANDALL SQUARE, SUITE 205, PROVIDENCE, RI, 02904

Plan administrator’s name and address
Administrator’s EIN 050343024
Plan administrator’s name OB GYN ASSOCIATES, INC
Plan administrator’s address ONE RANDALL SQUARE, SUITE 205, PROVIDENCE, RI, 02904
Administrator’s telephone number 4013316980
OB GYN ASSOCIATES,INC PROFIT SHARING SAVINGS PLAN 2010 050343024 2011-09-28 OB GYN ASSOCIATES, INC 75
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1971-02-01
Business code 621111
Sponsor’s telephone number 4013316980
Plan sponsor’s address ONE RANDALL SQUARE, SUITE 205, PROVIDENCE, RI, 02904

Plan administrator’s name and address
Administrator’s EIN 050343024
Plan administrator’s name OB GYN ASSOCIATES, INC
Plan administrator’s address ONE RANDALL SQUARE, SUITE 205, PROVIDENCE, RI, 02904
Administrator’s telephone number 4013316980

Signature of
Role Plan administrator
Date 2011-09-28
Name of individual signing JOHN J BERT
Valid signature Filed with authorized/valid electronic signature
OB GYN ASSOCIATES, INC PROFIT SHARING SAVINGS PLA 2009 050343024 2010-07-07 OB GYN ASSOCIATES, INC 78
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1971-02-01
Business code 621111
Sponsor’s telephone number 4013316980
Plan sponsor’s address ONE RANDALL SQUARE, SUITE 205, PROVIDENCE, RI, 02904

Plan administrator’s name and address
Administrator’s EIN 050343024
Plan administrator’s name OB GYN ASSOCIATES, INC
Plan administrator’s address ONE RANDALL SQUARE, SUITE 205, PROVIDENCE, RI, 02904
Administrator’s telephone number 4013316980

Signature of
Role Plan administrator
Date 2010-07-07
Name of individual signing JOHN J BERT MD
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
WILLIAM F. CHARLAND, CPA Agent 18 IMPERIAL PLACE, PROVIDENCE, RI, 02903, USA

PRESIDENT

Name Role Address
JOHN J. BERT MD PRESIDENT ONE RANDALL SQUARE PROVIDENCE, RI 02904 USA

Filings

Number Name File Date
201629285560 Articles of Dissolution 2016-12-30
201690288370 Annual Report 2016-01-08
201552985630 Annual Report 2015-01-08
201450422480 Statement of Change of Registered/Resident Agent 2014-11-26
201433790690 Annual Report 2014-01-21
201309896080 Annual Report 2013-01-16
201288246810 Annual Report 2012-01-19
201173649160 Annual Report 2011-01-18
201057475960 Annual Report 2010-01-27
200940984600 Annual Report 2009-01-23

Related by officers

WILLIAM F. CHARLAND, CPA

RANDALL SQUARE ASSOCIATES, LLC

Related by address

ONE RANDALL SQUARE, PROVIDENCE, RI, 02904, USA

Manoel A. Falcao, M.D., Ltd. Henry S. Urbaniak, Jr., M.D., Inc. RANDALL SURGICAL GROUP, INC. The Rhode Island Gastroenterology Society Moshassuck Non-Invasive Laboratory, Inc. N.E. Health Care Management Services, Inc. RANDALL SQUARE ASSOCIATES, LLC RX Realty Associates, LLC

Date of last update: 06 Oct 2024

Sources: Rhode Island Department of State

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