| Name: | LAKE MISHNOCK VOLUNTEER FIRE COMPANY |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 20 Jun 1951 (74 years ago) |
| Identification Number: | 000026178 |
| ZIP code: | 02817 |
| County: | Kent County |
| Principal Address: | 166 MISHNOCK ROAD, WEST GREENWICH, RI, 02817, USA |
| Purpose: | PROVIDING FOR THE PROTECTION AND PRESERVATION OF LIFE AND PROPERTY, BOTH REAL AND PERSONAL, IN THE LAKE MISHNOCK FIRE DISTRICT |
| NAICS: | 624230 - Emergency and Other Relief Services |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851374508 | 2005-11-28 | 2013-03-15 | PO BOX 20104, CRANSTON, RI, 029200927, US | 166 MISHNOCK RD, W GREENWICH, RI, 028171669, US | |||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 401-572-3120 |
| Fax | 4015723351 |
| Phone | +1 401-397-7353 |
Authorized person
| Name | JAMES R GALLIGAN JR. |
| Role | CAPTAIN |
| Phone | 4013977353 |
Taxonomy
| Taxonomy Code | 341600000X - Ambulance |
| License Number | 50 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CHIP |
| Number | BQ409256 |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 0000007822 |
| State | RI |
| Issuer | MEDICAID |
| Number | 1709119 |
| State | MA |
| Issuer | MEDICAID |
| Number | 9007822 |
| State | RI |
| Issuer | HARVARD PILGRIM |
| Number | 703427 |
| Name | Role | Address |
|---|---|---|
| NICHOLAS PEREIRA | Agent | 166 MISHNOCK ROAD, WEST GREENWICH, RI, 02817, USA |
| Name | Role | Address |
|---|---|---|
| DAN BROWN | PRESIDENT | 96 HARRIS AVENUE WEST WARWICK, RI 02893 USA |
| Name | Role | Address |
|---|---|---|
| JEREMY NERBONNE | TREASURER | 19 MARYLAND DR WEST WARWICK, RI 02893 USA |
| Name | Role | Address |
|---|---|---|
| BRIANNA PROCTOR | SECRETARY | 198 ASYLUM RD WARWICK, RI 02886 USA |
| Name | Role | Address |
|---|---|---|
| MATT PETTIGREW | VICE PRESIDENT | 165 SHENANDOAH RD WARWICK, RI 02886 USA |
| Name | Role | Address |
|---|---|---|
| PETER GARDNER | DIRECTOR | 399 MISHNOCK ROAD WEST GREENWICH, RI 02817 USA |
| MATT PETTIGREW | DIRECTOR | 165 SHENANDOAH RD WARWICK, RI 02886 USA |
| DAN BROWN | DIRECTOR | 96 HARRIS AVE WARWICK, RI 02893 USA |
| Number | Name | File Date |
|---|---|---|
| 202446686110 | Annual Report | 2024-02-17 |
| 202342450130 | Annual Report | 2023-10-26 |
| 202342449710 | Reinstatement | 2023-10-26 |
| 202341626130 | Revocation Certificate For Failure to File the Annual Report for the Year | 2023-09-13 |
| 202340179330 | Statement of Change of Registered/Resident Agent | 2023-08-07 |
| 202338503590 | Revocation Notice For Failure to File An Annual Report | 2023-06-20 |
| 202213665650 | Annual Report | 2022-03-29 |
| 202198596190 | Annual Report | 2021-06-24 |
| 202043173770 | Annual Report | 2020-06-23 |
| 201908694140 | Annual Report | 2019-07-31 |
Date of last update: 06 Oct 2024
Sources: Rhode Island Department of State
