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  5. St. Joseph Health Services of Rhode Island

St. Joseph Health Services of Rhode Island

Company Details

Name: St. Joseph Health Services of Rhode Island
Jurisdiction: Rhode Island
Entity type: Domestic Non-Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 02 Jan 1970 (55 years ago)
Identification Number: 000030205
ZIP code: 02903
County: Providence County
Principal Address: C/O ONE CITIZENS PLAZA 10TH FLOOR, PROVIDENCE, RI, 02903, USA
Purpose: OPERATION OF A HOSPITAL JANUARY SESSION 1970
NAICS: 622110 - General Medical and Surgical Hospitals
Fictitious names: Pediatric Dental Associates (trading name, 2009-06-19 - )
Historical names: St. Joseph Hospital

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1114186715 2008-06-09 2008-06-09 200 HIGH SERVICE AVE, 4TH FL MARION HALL, NORTH PROVIDENCE, RI, 029045113, US 21 PEACE ST, PROVIDENCE, RI, 029071510, US

Contacts
Phone +1 401-456-3309
Fax 4014563762

Authorized person
Name MR. JOHN FOGERTY
Role PRESIDENT - CEO
Phone 4014563309

Taxonomy
Taxonomy Code 133N00000X - Nutritionist
License Number HOS00110
State RI
Is Primary No
Taxonomy Code 171R00000X - Interpreter
License Number HOS00110
State RI
Is Primary No
Taxonomy Code 207Q00000X - Family Medicine Physician
License Number HOS00110
State RI
Is Primary Yes
Taxonomy Code 207RE0101X - Endocrinology, Diabetes & Metabolism Physician
License Number HOS001100
State RI
Is Primary No
Taxonomy Code 207V00000X - Obstetrics & Gynecology Physician
License Number HOS00110
State RI
Is Primary No

Other Provider Identifiers
Issuer PROGROUP (NHP)
Number 2127
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND 403(B) SAVINGS PLAN 2020 050259026 2022-01-04 ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-10-01
Business code 622000
Sponsor’s telephone number 4014563000
Plan sponsor’s address 200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2022-01-04
Name of individual signing THOMAS HEMMENDINGER
Valid signature Filed with authorized/valid electronic signature
ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND 403(B) SAVINGS PLAN 2019 050259026 2021-05-04 ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-10-01
Business code 622000
Sponsor’s telephone number 4014563000
Plan sponsor’s address 200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2021-05-04
Name of individual signing DAVID HIRSCH
Valid signature Filed with authorized/valid electronic signature
ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND 403(B) SAVINGS PLAN 2018 050259026 2019-12-02 ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-10-01
Business code 622000
Sponsor’s telephone number 4014563000
Plan sponsor’s address 200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2019-12-02
Name of individual signing DAVID HIRSCH
Valid signature Filed with authorized/valid electronic signature
ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND 403(B) SAVINGS PLAN 2017 050259026 2019-06-25 ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-10-01
Business code 622000
Sponsor’s telephone number 4014563000
Plan sponsor’s address 200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2019-06-25
Name of individual signing DAVID HIRSCH
Valid signature Filed with authorized/valid electronic signature
ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND 403(B) SAVINGS PLAN 2016 050259026 2018-02-08 ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND 0
Three-digit plan number (PN) 002
Effective date of plan 2007-10-01
Business code 622000
Sponsor’s telephone number 4014563000
Plan sponsor’s address 200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2018-02-08
Name of individual signing DAVID HIRSCH
Valid signature Filed with authorized/valid electronic signature
ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND 403(B) SAVINGS PLAN 2016 050259026 2018-06-13 ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-10-01
Business code 622000
Sponsor’s telephone number 4014563000
Plan sponsor’s address 200 HIGH SERVICE AVENUE, NORTH PROVIDENCE, RI, 02904
ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND 403(B) SAVINGS PLAN 2015 050259026 2017-06-06 ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-10-01
Business code 622000
Sponsor’s telephone number 4014563000
Plan sponsor’s address 200 HIGH SERVICE AVENUE, NORTH PROVIDENCE, RI, 02904

Plan administrator’s name and address
Administrator’s EIN 050259026
Plan administrator’s name ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND
Plan administrator’s address 200 HIGH SERVICE AVENUE, NORTH PROVIDENCE, RI, 02904
Administrator’s telephone number 4014563000

Agent

Name Role Address
STEPHEN F. DEL SESTO Agent ONE CITIZENS PLAZA 10TH FLOOR, PROVIDENCE, RI, 02903, USA

Events

Type Date Old Value New Value
Merged 2004-10-27 H.E.L.P. LEAD SAFE CENTER, INC. on St. Joseph Health Services of Rhode Island
Merged 2003-02-27 Healthcare Management and Billing Services, Inc. on St. Joseph Health Services of Rhode Island
Name Change 1995-07-13 St. Joseph Hospital St. Joseph Health Services of Rhode Island

Filings

Number Name File Date
202450020700 Statement of Change of Registered/Resident Agent Office 2024-04-02
202447751150 Annual Report 2024-02-26
202328466140 Annual Report 2023-02-09
202325632980 Statement of Change of Registered/Resident Agent 2023-01-04
202214587230 Annual Report 2022-04-08
202198559780 Annual Report 2021-06-23
202043732670 Annual Report 2020-06-29
202033798750 Statement of Change of Registered/Resident Agent 2020-02-05
201994158540 Annual Report 2019-05-24
201866153750 Annual Report 2018-05-18

Related by officers

STEPHEN F. DEL SESTO

Roger Williams Hospital CharterCARE Community Board Cook & Brown Public House, Ltd.

Related by address

C/O ONE CITIZENS PLAZA 10TH FLOOR, PROVIDENCE, RI, 02903, USA

CharterCARE Community Board

Date of last update: 06 Oct 2024

Sources: Rhode Island Department of State

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