| Name: | CHARLESTOWN AMBULANCE AND RESCUE SERVICE, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 15 Mar 1971 (54 years ago) |
| Identification Number: | 000028618 |
| ZIP code: | 02813 |
| County: | Washington County |
| Principal Address: | 4891 OLD POST RD, CHARLESTOWN, RI, 02813, USA |
| Purpose: | EMERGENCY MEDICAL TRANSPORTATION FOR THE SICK AND INJURED |
| NAICS: | 624230 - Emergency and Other Relief Services |
| Historical names: |
CHARLESTOWN AMBULANCE SERVICE INC. |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528056991 | 2005-10-11 | 2024-01-18 | PO BOX 346, CHARLESTOWN, RI, 028130346, US | 4891 OLD POST RD, CHARLESTOWN, RI, 028131819, US | |||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||
| Phone | +1 401-364-3742 |
| Fax | 4013645438 |
Authorized person
| Name | ANDREW KETTLE |
| Role | CHIEF |
| Phone | 4013643742 |
Taxonomy
| Taxonomy Code | 341600000X - Ambulance |
| License Number | 10 |
| State | RI |
| Is Primary | No |
| Taxonomy Code | 3416L0300X - Land Ambulance |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 9009951 |
| State | RI |
| Issuer | RAILROAD MEDICARE |
| Number | 590007904 |
| Name | Role | Address |
|---|---|---|
| MARY MACARI | Agent | 4891 OLD POST ROAD P.O. BOX 346, CHARLESTOWN, RI, 02813, USA |
| Name | Role | Address |
|---|---|---|
| BETHANY GINGERELLA | PRESIDENT | 4891 OLD POST ROAD CHARLESTOWN, RI 02813 USA |
| Name | Role | Address |
|---|---|---|
| RICH LUTZ | SECRETARY | 4891 OLD POST RD CHARLESTOWN, RI 02813 USA |
| Name | Role | Address |
|---|---|---|
| ANDREW D KETTLE | CHIEF OF DEPARTMENT | 4891 OLD POST RD CHARLESTOWN, RI 02813 USA |
| Name | Role | Address |
|---|---|---|
| STEPHEN MCCANDLESS | DIRECTOR | 4891 OLD POST ROAD CHARLESTOWN, RI 02813 USA |
| LISA SCHIPRITT | DIRECTOR | 14 NARROW LANE CHARLESTOWN, RI 02813 USA |
| ALAN ALI | DIRECTOR | 4891 OLD POST ROAD CHARLESTOWN, RI 02813 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 1992-11-25 | CHARLESTOWN AMBULANCE SERVICE INC. | CHARLESTOWN AMBULANCE AND RESCUE SERVICE, INC. |
| Number | Name | File Date |
|---|---|---|
| 202454114180 | Annual Report | 2024-05-09 |
| 202330064800 | Annual Report | 2023-03-10 |
| 202221329380 | Annual Report | 2022-07-15 |
| 202220543480 | Revocation Notice For Failure to File An Annual Report | 2022-06-28 |
| 202199346000 | Annual Report | 2021-07-17 |
| 202199345940 | Statement of Change of Registered/Resident Agent | 2021-07-17 |
| 202044925710 | Annual Report | 2020-07-17 |
| 201930603420 | Annual Report | 2019-12-23 |
| 201927072880 | Revocation Notice For Failure to File An Annual Report | 2019-11-06 |
| 201872641410 | Annual Report | 2018-07-20 |
Date of last update: 06 Oct 2024
Sources: Rhode Island Department of State
