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Kent County Memorial Hospital

Company Details

Name: Kent County Memorial Hospital
Jurisdiction: Rhode Island
Entity type: Domestic Non-Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 25 Apr 1946 (79 years ago)
Identification Number: 000031486
ZIP code: 02886
County: Kent County
Principal Address: 455 TOLL GATE ROAD, WARWICK, RI, 02886, USA
Purpose: ENACTED BY THE GENERAL ASSEMBLY DURING THE JANUARY SESSION OF 1946 EFFECTIVE 04/25/1946. NON PROFIT COMMUNITY HOSPITAL JANUARY SESSION 1946
Fictitious names: Kent Hospital (trading name, 2015-08-26 - )
Kent Hospitalists (trading name, 1999-06-08 - )
Kent Primary Care Associates (trading name, 1999-06-08 - )
Historical names: KENT COUNTY MEMORIAL HOSPITAL

Industry & Business Activity

NAICS

622110 General Medical and Surgical Hospitals

This industry comprises establishments known and licensed as general medical and surgical hospitals primarily engaged in providing diagnostic and medical treatment (both surgical and nonsurgical) to inpatients with any of a wide variety of medical conditions. These establishments maintain inpatient beds and provide patients with food services that meet their nutritional requirements. These hospitals have an organized staff of physicians and other medical staff to provide patient care services. These establishments usually provide other services, such as outpatient services, anatomical pathology services, diagnostic X-ray services, clinical laboratory services, operating room services for a variety of procedures, and pharmacy services. Learn more at the U.S. Census Bureau

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1922621614 2020-05-28 2020-05-28 455 TOLL GATE RD, WARWICK, RI, 028862759, US 455 TOLL GATE RD, WARWICK, RI, 028862759, US

Contacts

Phone +1 401-737-7000

Authorized person

Name HEATHER-ROSE MATTIAS
Role DIRECTOR CONTRACT ADMINISTRATION
Phone 4019218535

Taxonomy

Taxonomy Code 291U00000X - Clinical Medical Laboratory
Is Primary Yes

Legal Entity Identifier

LEI number Registered As Jurisdiction Of Formation General Category Entity Status Entity created at
549300YH7OVBZIIB8I51 000031486 US-RI GENERAL ACTIVE No data

Addresses

Legal C/O Joseph A. Dipietro, Esq, 455 Toll Gate Road, Warwick, US-RI, US, 02886
Headquarters C/O Joseph A. Dipietro, Esq, 455 Toll Gate Road, Warwick, US-RI, US, 02886

Registration details

Registration Date 2013-08-22
Last Update 2023-08-04
Status LAPSED
Next Renewal 2014-08-22
LEI Issuer 5493001KJTIIGC8Y1R12
Corroboration Level FULLY_CORROBORATED
Data Validated As 000031486

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KENT COUNTY MEMORIAL HOSPITAL 401(K) PROFIT SHARING PLAN & TRUST 2020 056013557 2022-06-08 KENT COUNTY MEMORIAL HOSPITAL 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 522130
Sponsor’s telephone number 4017377010
Plan sponsor’s address 455 TOLL GATE RD., WARWICK, RI, 028862759

Plan administrator’s name and address

Administrator’s EIN 050125860
Plan administrator’s name NAVIGANT CREDIT UNION C/O JEFF LEMOS
Plan administrator’s address 1005 DOUGLAS PIKE, SMITHFIELD, RI, 029171206
Administrator’s telephone number 4012334304

Signature of

Role Plan administrator
Date 2022-06-08
Name of individual signing JEFFREY P. LEMOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-06-08
Name of individual signing JEFFREY P LEMOS
Valid signature Filed with authorized/valid electronic signature
KENT COUNTY MEMORIAL HOSPITAL 401(K) PROFIT SHARING PLAN & TRUST 2019 056013557 2020-10-15 KENT COUNTY MEMORIAL HOSPITAL 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 522130
Sponsor’s telephone number 4017377010
Plan sponsor’s address KENT HOSPITAL CREDIT UNION, 455 TOLL GATE RD, WARWICK, RI, 028862759

Signature of

Role Plan administrator
Date 2020-10-15
Name of individual signing JEFFREY LEMOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-15
Name of individual signing JEFFREY LEMOS
Valid signature Filed with authorized/valid electronic signature
KENT COUNTY MEMORIAL HOSPITAL 401 K PROFIT SHARING PLAN TRUST 2018 056013557 2019-07-31 KENT COUNTY MEMORIAL HOSPITAL 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 522130
Sponsor’s telephone number 4017377010
Plan sponsor’s address KENT HOSPITAL CREDIT UNION, ATT GENE LECO 455 TOLL GATE RD, WARWICK, RI, 02886

Signature of

Role Plan administrator
Date 2019-07-31
Name of individual signing EUGENE LECO
Valid signature Filed with authorized/valid electronic signature
KENT COUNTY MEMORIAL HOSPITAL 401 K PROFIT SHARING PLAN TRUST 2017 056013557 2018-08-15 KENT COUNTY MEMORIAL HOSPITAL 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 522130
Sponsor’s telephone number 4017377010
Plan sponsor’s address KENT HOSPITAL CREDIT UNION, ATT GENE LECO 455 TOLL GATE RD, WARWICK, RI, 02886

Signature of

Role Plan administrator
Date 2018-08-15
Name of individual signing EUGENE LECO
Valid signature Filed with authorized/valid electronic signature
KENT COUNTY MEMORIAL HOSPITAL 401 K PROFIT SHARING PLAN TRUST 2015 056013557 2016-07-28 KENT COUNTY MEMORIAL HOSPITAL 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 522130
Sponsor’s telephone number 4017377010
Plan sponsor’s address KENT HOSPITAL CREDIT UNION, ATT GENE LECO 455 TOLL GATE RD, WARWICK, RI, 028862770

Signature of

Role Plan administrator
Date 2016-07-28
Name of individual signing EUGENE LECO
Valid signature Filed with authorized/valid electronic signature
KENT COUNTY MEMORIAL HOSPITAL 401 K PROFIT SHARING PLAN TRUST 2014 056013557 2015-07-27 KENT COUNTY MEMORIAL HOSPITAL 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 522130
Sponsor’s telephone number 4017377010
Plan sponsor’s address KENT HOSPITAL CREDIT UNION, ATT GENE LECO 455 TOLL GATE RD, WARWICK, RI, 02886

Signature of

Role Plan administrator
Date 2015-07-27
Name of individual signing EUGENE LECO
Valid signature Filed with authorized/valid electronic signature
KENT COUNTY MEMORIAL HOSPITAL 401 K PROFIT SHARING PLAN TRUST 2013 056013557 2014-08-07 KENT COUNTY MEMORIAL HOSPITAL 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 522130
Sponsor’s telephone number 4017377010
Plan sponsor’s address KENT HOSPITAL CREDIT UNION, ATT GENE LECO 455 TOLL GATE RD, WARWICK, RI, 02886

Signature of

Role Plan administrator
Date 2014-08-07
Name of individual signing EUGENE LECO
Valid signature Filed with authorized/valid electronic signature
KENT COUNTY MEMORIAL HOSPITAL 401 K PROFIT SHARING PLAN TRUST 2012 056013557 2013-07-15 KENT COUNTY MEMORIAL HOSPITAL 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 522130
Sponsor’s telephone number 4017377010
Plan sponsor’s address KENT HOSPITAL CREDIT UNION, ATT GENE LECO 455 TOLL GATE RD, WARWICK, RI, 02886

Signature of

Role Plan administrator
Date 2013-07-15
Name of individual signing KENT COUNTY MEMORIAL HOSPITAL
Valid signature Filed with authorized/valid electronic signature
KENT COUNTY MEMORIAL HOSPITAL 401 K PROFIT SHARING PLAN TRUST 2011 056013557 2012-07-31 KENT COUNTY MEMORIAL HOSPITAL 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 522130
Sponsor’s telephone number 4017377010
Plan sponsor’s address KENT HOSPITAL CREDIT UNION, ATT GENE LECO 455 TOLL GATE RD, WARWICK, RI, 02886

Plan administrator’s name and address

Administrator’s EIN 056013557
Plan administrator’s name KENT COUNTY MEMORIAL HOSPITAL
Plan administrator’s address KENT HOSPITAL CREDIT UNION, ATT GENE LECO 455 TOLL GATE RD, WARWICK, RI, 02886
Administrator’s telephone number 4017377010

Signature of

Role Plan administrator
Date 2012-07-31
Name of individual signing KENT COUNTY MEMORIAL HOSPITAL
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SUZANNE DUNI BRIGGS, JD,RN,BSN Agent 455 TOLL GATE ROAD RISK MANAGEMENT DEPT., WARWICK, RI, 02886, USA

SECRETARY

Name Role Address
JAMES BOTVIN SECRETARY 12 BAGY WRINKLE COVE WARREN, RI 02885 USA

DIRECTOR

Name Role Address
R. STEPHEN MANTY DIRECTOR 110 ROYAL LITTLE DRIVE PROVIDENCE, RI 02904 USA
JUDITH REMONDI DIRECTOR 258 BRIDLE TRAIL ROAD NEEDHAM, MA 02492 USA
KEVIN BAILL MD DIRECTOR 345 BLACKSTONE BLVD PROVIDENCE, RI 02906 USA
CAROLYNN MASTERS PH.D., RN DIRECTOR RHODE ISLAND COLLEGE, FLS 158-600 MOUNT PLEASANT AVENUE PROVIDENCE, RI 02908 USA
PETER R. PHILLIPS DIRECTOR 156 WESTMINSTER STREET PROVIDENCE, RI 02903 USA
CHARLES R REPPUCCI DIRECTOR 215 SUNNYBROOK FARM ROAD NARRAGANSETT, RI 02882 USA
ANA TUYA FULTON MD DIRECTOR 4 RICHMOND SQUARE PROVIDENCE, RI 02906 USA
PATRICK J. MURRAY, JR. DIRECTOR 255 BOXWOOD LANE BRIDGEWATER, MA 02324 USA
MARIBETH WILLIAMSON DIRECTOR 450 WAKEFIELD STREET WEST WARWICK, RI 02893 USA
JOSEPH J. MCGAIR, ESQ. DIRECTOR 92 SANDY LANE WARWICK, RI 02889 USA

ASSISTANT SECRETARY

Name Role Address
ASHLEY TAYLOR ESQ. ASSISTANT SECRETARY 4 RICHMOND SQUARE PROVIDENCE, RI 02906 USA

PRESIDENT

Name Role Address
PAARI GOPALAKRISHNAN MD PRESIDENT 455 TOLL GATE ROAD WARWICK, RI 02886 USA

TREASURER

Name Role Address
R. STEPHEN MANTY TREASURER 110 ROYAL LITTLE DRIVE PROVIDENCE, RI 02904 USA

EX OFFICIO DIRECTOR

Name Role Address
MICHAEL WAGNER MD EX OFFICIO DIRECTOR 4 RICHMOND SQUARE PROVIDENCE, RI 02906 USA

ASSISTANT TREASURER

Name Role Address
TODD CONKLIN ASSISTANT TREASURER 4 RICHMOND SQUARE PROVIDENCE, RI 02906 USA

CHAIRPERSON

Name Role Address
GARY E. FURTADO CHAIRPERSON 15 BETH AVENUE WARREN, RI 02885 USA

VICE CHAIRPERSON

Name Role Address
R. STEPHEN MANTY VICE CHAIRPERSON 110 ROYAL LITTLE DRIVE PROVIDENCE, RI 02904 USA

Events

Type Date Old Value New Value
Name Change 1974-11-01 KENT COUNTY MEMORIAL HOSPITAL Kent County Memorial Hospital
Merged 1974-11-01 Providence Floating Hospital Association Kent County Memorial Hospital

Filings

Number Name File Date
202450605510 Annual Report 2024-04-10
202330163530 Annual Report 2023-03-08
202213264150 Annual Report 2022-03-22
202198180560 Annual Report 2021-06-11
202078361290 Annual Report 2020-12-03
201921926710 Statement of Change of Registered/Resident Agent 2019-10-01
201996116700 Annual Report 2019-06-10
201995476670 Statement of Change of Registered/Resident Agent 2019-06-05
201870270450 Annual Report 2018-06-22
201863120340 Statement of Change of Registered/Resident Agent 2018-04-30

USAspending Awards. Financial Assistance

FAIN Awarding Agency Assistance Listings Start Date End Date Description
C76HF19843 Department of Health and Human Services 93.887 - HEALTH CARE AND OTHER FACILITIES 2010-09-01 2011-09-30 HEALTH CARE AND OTHER FACILITIES
Recipient KENT COUNTY MEMORIAL HOSPITAL
Recipient Name Raw KENT COUNTY MEMORIAL HOSPITAL, INC
Recipient UEI NPXGTX5G5C74
Recipient DUNS 069855195
Recipient Address 455 TOLL GATE ROAD, WARWICK, KENT, RHODE ISLAND, 02886, UNITED STATES
Obligated Amount 198000.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
344754494 0112300 2020-05-18 455 TOLL GATE ROAD, WARWICK, RI, 02886
Inspection Type Fat/Cat
Scope Partial
Safety/Health Health
Close Conference 2020-05-18
Case Closed 2020-10-27

Related Activity

Type Accident
Activity Nr 1583482

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
05-0258896 Corporation Unconditional Exemption 4 RICHMOND SQUARE 4TH FLOOR, PROVIDENCE, RI, 02906-5117 1955-01
In Care of Name % KATHY TOPOR
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 2023-09
Asset 50,000,000 to greater
Income 50,000,000 to greater
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Sep
Asset Amount 273921260
Income Amount 646305441
Form 990 Revenue Amount 646011139
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 KENT COUNTY MEMORIAL HOSPITAL
EIN 05-0258896
Tax Period 202209
Filing Type E
Return Type 990
File View File
Organization Name KENT COUNTY MEMORIAL HOSPITAL
EIN 05-0258896
Tax Period 202109
Filing Type E
Return Type 990
File View File
Organization Name KENT COUNTY MEMORIAL HOSPITAL
EIN 05-0258896
Tax Period 202009
Filing Type E
Return Type 990
File View File
Organization Name KENT COUNTY MEMORIAL HOSPITAL
EIN 05-0258896
Tax Period 201909
Filing Type E
Return Type 990
File View File
Organization Name KENT COUNTY MEMORIAL HOSPITAL
EIN 05-0258896
Tax Period 201909
Filing Type P
Return Type 990T
File View File
Organization Name KENT COUNTY MEMORIAL HOSPITAL
EIN 05-0258896
Tax Period 201809
Filing Type P
Return Type 990T
File View File
Organization Name KENT COUNTY MEMORIAL HOSPITAL
EIN 05-0258896
Tax Period 201809
Filing Type E
Return Type 990
File View File
Organization Name KENT COUNTY MEMORIAL HOSPITAL
EIN 05-0258896
Tax Period 201809
Filing Type P
Return Type 990T
File View File
Organization Name KENT COUNTY MEMORIAL HOSPITAL
EIN 05-0258896
Tax Period 201709
Filing Type E
Return Type 990
File View File
Organization Name KENT COUNTY MEMORIAL HOSPITAL
EIN 05-0258896
Tax Period 201709
Filing Type E
Return Type 990T
File View File
Organization Name KENT COUNTY MEMORIAL HOSPITAL
EIN 05-0258896
Tax Period 201609
Filing Type E
Return Type 990
File View File
Organization Name KENT COUNTY MEMORIAL HOSPITAL
EIN 05-0258896
Tax Period 201609
Filing Type P
Return Type 990T
File View File

Date of last update: 06 Apr 2025

Sources: Rhode Island Department of State