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BLOCK ISLAND HEALTH SERVICES, INC.

Company Details

Name: BLOCK ISLAND HEALTH SERVICES, INC.
Jurisdiction: Rhode Island
Entity type: Domestic Non-Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 23 Jul 1984 (41 years ago)
Identification Number: 000027470
ZIP code: 02807
County: Washington County
Principal Address: PO BOX 919, BLOCK ISLAND, RI, 02807, USA
Purpose: PROVISION OF HEALTH CARE SERVICES

Industry & Business Activity

NAICS

813212 Voluntary Health Organizations

This U.S. industry comprises establishments primarily engaged in raising funds for health related research, such as disease (e.g., heart, cancer, diabetes) prevention, health education, and patient services. Learn more at the U.S. Census Bureau

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1639649452 2018-12-05 2018-12-05 PO BOX 919, BLOCK ISLAND, RI, 028070919, US 6 PAYNE ROAD, BLOCK ISLAND, RI, 028070919, US

Contacts

Phone +1 401-466-2974
Fax 4014665476

Authorized person

Name PATRICIA ANN MURPHY
Role BILLING COORDINATOR
Phone 4014662974

Taxonomy

Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 9002424
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLOCK ISLAND HEALTH SERVICES, INC. 403(B) PLAN 2023 222570482 2024-06-10 BLOCK ISLAND HEALTH SERVICES, INC. 13
Three-digit plan number (PN) 001
Effective date of plan 2021-01-01
Business code 621399
Sponsor’s telephone number 4014662974
Plan sponsor’s address 6 PAYNE ROAD, BLOCK ISLAND, RI, 02807

Signature of

Role Plan administrator
Date 2024-06-10
Name of individual signing THOMAS WARCUP
Valid signature Filed with authorized/valid electronic signature
BLOCK ISLAND HEALTH SERVICES, INC. 403(B) PLAN 2023 222570482 2024-06-17 BLOCK ISLAND HEALTH SERVICES, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-01-01
Business code 621399
Sponsor’s telephone number 4014662974
Plan sponsor’s address 6 PAYNE ROAD, BLOCK ISLAND, RI, 02807

Signature of

Role Plan administrator
Date 2024-06-17
Name of individual signing THOMAS WARCUP
Valid signature Filed with authorized/valid electronic signature
BLOCK ISLAND HEALTH SERVICES, INC. 403(B) PLAN 2022 222570482 2023-02-21 BLOCK ISLAND HEALTH SERVICES, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-01-01
Business code 621399
Sponsor’s telephone number 4014662974
Plan sponsor’s address 6 PAYNE ROAD, BLOCK ISLAND, RI, 02807

Signature of

Role Plan administrator
Date 2023-02-21
Name of individual signing DEBBI-JO HORTON
Valid signature Filed with authorized/valid electronic signature
BLOCK ISLAND HEALTH SERVICES, INC. 403(B) PLAN 2021 222570482 2022-02-08 BLOCK ISLAND HEALTH SERVICES, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-01-01
Business code 621399
Sponsor’s telephone number 4014662974
Plan sponsor’s address 6 PAYNE ROAD, BLOCK ISLAND, RI, 02807

Agent

Name Role Address
JAMES DUTRA Agent 117 METRO CENTER BLVD SUITE 2007, WARWICK, RI, 02886, USA

PRESIDENT

Name Role Address
SUSAN STOVER PRESIDENT PO BOX 1435 BLOCK ISLAND, RI 02807 USA

TREASURER

Name Role Address
TOM MURPHY TREASURER PO BOX 919 BLOCK ISLAND, RI 02807 USA

SECRETARY

Name Role Address
BRIAN OTT SECRETARY PO BOX 919 BLOCK ISLAND, RI 02807 USA

CEO

Name Role Address
THOMAS WARCUP MD CEO PO BOX 919 BLOCK ISLAND, RI 02807 USA

VICE PRESIDENT

Name Role Address
LAURA PARSONS VICE PRESIDENT PO BOX 919 BLOCK ISLAND, RI 02807 USA

DIRECTOR

Name Role Address
PAM AUSTEN DIRECTOR PO BOX 919 BLOCK ISLAND, RI 02807 USA
BILL MILLS DIRECTOR PO BOX 919 BLOCK ISLAND, RI 02807 USA
PAM RICHTER DIRECTOR PO BOX 919 BLOCK ISLAND, RI 02807 USA
KIRK LITTLEFIELD DIRECTOR PO BOX 919 BLOCK ISLAND, RI 02807 USA
ROBIN LEWIS DIRECTOR PO BOX 919 BLOCK ISLAND, RI 02807 USA
SHARON WEINBERG DIRECTOR PO BOX 919 BLOCK ISLAND, RI 02807 USA

Filings

Number Name File Date
202452395130 Statement of Change of Registered/Resident Agent 2024-04-24
202452394160 Annual Report 2024-04-24
202329384470 Annual Report 2023-02-27
202214418020 Annual Report 2022-04-11
202198697950 Annual Report 2021-06-28
202041326970 Annual Report 2020-06-02
202034138050 Annual Report 2020-02-10
202034137990 Reinstatement 2020-02-10
202032375600 Revocation Certificate For Failure to File the Annual Report for the Year 2020-01-15
201927016190 Revocation Notice For Failure to File An Annual Report 2019-11-06

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
22-2570482 Corporation Unconditional Exemption PO BOX 919, BLOCK ISLAND, RI, 02807-0919 1985-01
In Care of Name -
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Hospital or medical research organization 170(b)(1)(A)(iii)
Tax Period 2023-12
Asset 10,000,000 to 49,999,999
Income 1,000,000 to 4,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 10875237
Income Amount 2726856
Form 990 Revenue Amount 2726856
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data

Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)

Organization Name BLOCK ISLAND HEALTH SERVICES INC
EIN 22-2570482
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name BLOCK ISLAND HEALTH SERVICES INC
EIN 22-2570482
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name BLOCK ISLAND HEALTH SERVICES INC
EIN 22-2570482
Tax Period 202012
Filing Type E
Return Type 990
File View File
Organization Name BLOCK ISLAND HEALTH SERVICES INC
EIN 22-2570482
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name BLOCK ISLAND HEALTH SERVICES INC
EIN 22-2570482
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name BLOCK ISLAND HEALTH SERVICES INC
EIN 22-2570482
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name BLOCK ISLAND HEALTH SERVICES INC
EIN 22-2570482
Tax Period 201512
Filing Type E
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3826658400 2021-02-05 0165 PPS 6 Payne Rd, Block Island, RI, 02807-7761
Loan Status Date 2021-09-16
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 175285
Loan Approval Amount (current) 175285
Undisbursed Amount 0
Franchise Name -
Lender Location ID 65777
Servicing Lender Name The Washington Trust Company of Westerly
Servicing Lender Address 23 Broad St, WESTERLY, RI, 02891-1879
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Block Island, WASHINGTON, RI, 02807-7761
Project Congressional District RI-02
Number of Employees 10
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 65777
Originating Lender Name The Washington Trust Company of Westerly
Originating Lender Address WESTERLY, RI
Gender Male Owned
Veteran Unanswered
Forgiveness Amount 176239.33
Forgiveness Paid Date 2021-08-27
9471987003 2020-04-09 0165 PPP 6 Payne Road P.O. Box 919, BLOCK ISLAND, RI, 02807-7761
Loan Status Date 2021-03-11
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 175284
Loan Approval Amount (current) 175284
Undisbursed Amount 0
Franchise Name -
Lender Location ID 65777
Servicing Lender Name The Washington Trust Company of Westerly
Servicing Lender Address 23 Broad St, WESTERLY, RI, 02891-1879
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address BLOCK ISLAND, WASHINGTON, RI, 02807-7761
Project Congressional District RI-02
Number of Employees 10
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 65777
Originating Lender Name The Washington Trust Company of Westerly
Originating Lender Address WESTERLY, RI
Gender Male Owned
Veteran Unanswered
Forgiveness Amount 176676.53
Forgiveness Paid Date 2021-02-02

Date of last update: 06 Apr 2025

Sources: Rhode Island Department of State