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 |
NAICS
622110 General Medical and Surgical HospitalsThis 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
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 | |||||||||||||
|
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 |
LEI number | Registered As | Jurisdiction Of Formation | General Category | Entity Status | Entity created at | |||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
549300YH7OVBZIIB8I51 | 000031486 | US-RI | GENERAL | ACTIVE | No data | |||||||||||||||||||
|
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 |
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 | |||||||||||||||||||||||||||||||||||||||||
|
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
Name | Role | Address |
---|---|---|
SUZANNE DUNI BRIGGS, JD,RN,BSN | Agent | 455 TOLL GATE ROAD RISK MANAGEMENT DEPT., WARWICK, RI, 02886, USA |
Name | Role | Address |
---|---|---|
JAMES BOTVIN | SECRETARY | 12 BAGY WRINKLE COVE WARREN, RI 02885 USA |
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 |
Name | Role | Address |
---|---|---|
ASHLEY TAYLOR ESQ. | ASSISTANT SECRETARY | 4 RICHMOND SQUARE PROVIDENCE, RI 02906 USA |
Name | Role | Address |
---|---|---|
PAARI GOPALAKRISHNAN MD | PRESIDENT | 455 TOLL GATE ROAD WARWICK, RI 02886 USA |
Name | Role | Address |
---|---|---|
R. STEPHEN MANTY | TREASURER | 110 ROYAL LITTLE DRIVE PROVIDENCE, RI 02904 USA |
Name | Role | Address |
---|---|---|
MICHAEL WAGNER MD | EX OFFICIO DIRECTOR | 4 RICHMOND SQUARE PROVIDENCE, RI 02906 USA |
Name | Role | Address |
---|---|---|
TODD CONKLIN | ASSISTANT TREASURER | 4 RICHMOND SQUARE PROVIDENCE, RI 02906 USA |
Name | Role | Address |
---|---|---|
GARY E. FURTADO | CHAIRPERSON | 15 BETH AVENUE WARREN, RI 02885 USA |
Name | Role | Address |
---|---|---|
R. STEPHEN MANTY | VICE CHAIRPERSON | 110 ROYAL LITTLE DRIVE PROVIDENCE, RI 02904 USA |
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 |
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 |
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 | |||||||||||||||||||||
|
Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
344754494 | 0112300 | 2020-05-18 | 455 TOLL GATE ROAD, WARWICK, RI, 02886 | |||||||||||||||||
|
Type | Accident |
Activity Nr | 1583482 |
EIN | Type of Organization | Exempt Organization Status | Address | Ruling Date | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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05-0258896 | Corporation | Unconditional Exemption | 4 RICHMOND SQUARE 4TH FLOOR, PROVIDENCE, RI, 02906-5117 | 1955-01 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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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