| Name: | South County Hospital Healthcare System |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 16 Mar 1989 (36 years ago) |
| Identification Number: | 000054716 |
| ZIP code: | 02879 |
| County: | Washington County |
| Principal Address: | 100 KENYON AVENUE, WAKEFIELD, RI, 02879, USA |
| Purpose: | MAINTAINING A HOSPITAL FOR THE SICK, DISABLED AND INJURED |
| NAICS: | 622110 - General Medical and Surgical Hospitals |
| Fictitious names: |
New England Special Surgery Hospital (trading name, 2021-06-01 - ) South County Medical Group – Westerly Urgent Care (trading name, 2016-02-12 - ) South County Medical Group - East Greenwich Urgent Care (trading name, 2016-02-12 - ) South County Healthcare (trading name, 2015-05-07 - ) South County Health (trading name, 2015-05-07 - ) South County Medical Group - Wound Care (trading name, 2015-01-06 - ) South County Medical Group - South County Cardiology (trading name, 2015-01-06 - ) South County Medical Group - Shoreline Podiatry (trading name, 2015-01-06 - ) South County Medical Group - Shoreline Nephrology & Hypertension Associates (trading name, 2015-01-06 - ) South County Medical Group - Oncology/Hematology (trading name, 2015-01-06 - ) South County Medical Group - Infectious Disease and Lyme Disease (trading name, 2015-01-06 - ) South County Medical Group - Hospitalists (trading name, 2015-01-06 - ) South County Medical Group - General Surgery (trading name, 2015-01-06 - ) South County Medical Group - Endocrinology (trading name, 2015-01-06 - ) South County Medical Group - Center for Women's Health (Obstetrics & Gynecology) (trading name, 2015-01-06 - ) South County Medical Group - Behavioral Health (trading name, 2015-01-06 - ) South County Medical Group - Urgent Care & Occupational Health (trading name, 2015-01-06 - ) South County Medical Group - Westerly Primary Care (trading name, 2015-01-06 - ) South County Medical Group - Wakefield Primary Care (trading name, 2015-01-06 - ) South County Medical Group-East Greenwich Family Medicine (trading name, 2015-01-06 - ) South County Cardiology (trading name, 2013-03-15 - ) South County Hospital Center for Women's Health (trading name, 2008-11-12 - ) South County Hospital Medical & Wellness Center (trading name, 2008-09-25 - ) South County Hospital Orthopedics Center (trading name, 2007-04-24 - ) South County Healthcare Corporation (trading name, 2000-05-31 - ) South County Hospital (trading name, 1999-06-29 - ) Medical Answering Service of Southern Rhode Island (trading name, 1994-09-22 - ) |
| Historical names: |
South County Hospital, Inc. |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851746259 | 2016-05-04 | 2016-05-04 | 100 KENYON AVE, WAKEFIELD, RI, 028794216, US | 100 KENYON AVE, WAKEFIELD, RI, 028794216, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 401-788-1430 |
Authorized person
| Name | MS. CHRISTINE E STOUT |
| Role | FAMILY PRACTICE |
| Phone | 4017881430 |
Taxonomy
| Taxonomy Code | 282N00000X - General Acute Care Hospital |
| Is Primary | Yes |
| LEI number | Registered As | Jurisdiction Of Formation | General Category | Entity Status | Entity created at | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 549300EN44UX2EAKVV83 | 000054716 | US-RI | GENERAL | ACTIVE | 1989-03-16 | |||||||||||||||||||
|
||||||||||||||||||||||||
| Legal | C/O AARON ROBINSON, 100 KENYON AVENUE, WAKEFIELD, US-RI, US, 02879 |
| Headquarters | 100 Kenyon Avenue, Wakefield-Peacedale, US-RI, US, 02879 |
Registration details
| Registration Date | 2013-10-12 |
| Last Update | 2023-08-04 |
| Status | LAPSED |
| Next Renewal | 2023-07-06 |
| LEI Issuer | 5493001KJTIIGC8Y1R12 |
| Corroboration Level | FULLY_CORROBORATED |
| Data Validated As | 000054716 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SOUTH COUNTY HOSPITAL RETIREMENT PLAN | 2009 | 050445136 | 2011-07-15 | SOUTH COUNTY HOSPITAL, INC. | 901 | |||||||||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||||||||
| Administrator’s EIN | 050445136 |
| Plan administrator’s name | SOUTH COUNTY HOSPITAL, INC. |
| Plan administrator’s address | 100 KENYON AVENUE, WAKEFIELD, RI, 028794216 |
| Administrator’s telephone number | 4017828000 |
Number of participants as of the end of the plan year
| Active participants | 419 |
| Retired or separated participants receiving benefits | 211 |
| Other retired or separated participants entitled to future benefits | 257 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 13 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 1 |
Signature of
| Role | Plan administrator |
| Date | 2011-07-15 |
| Name of individual signing | MARGARET THOMAS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Plan sponsor’s mailing address | 100 KENYON AVENUE, WAKEFIELD, RI, 02879 |
| Plan sponsor’s address | 100 KENYON AVENUE, WAKEFIELD, RI, 02879 |
Plan administrator’s name and address
| Administrator’s EIN | 050445136 |
| Plan administrator’s name | SOUTH COUNTY HOSPITAL, INC. |
| Plan administrator’s address | 100 KENYON AVENUE, WAKEFIELD, RI, 02879 |
| Name | Role | Address |
|---|---|---|
| AARON ROBINSON | Agent | 100 KENYON AVENUE, WAKEFIELD, RI, 02879, USA |
| Name | Role | Address |
|---|---|---|
| AARON ROBINSON | PRESIDENT | 100 KENYON AVENUE WAKEFIELD, RI 02879 USA |
| Name | Role | Address |
|---|---|---|
| BETTY RAMBUR | TREASURER | 100 KENYON AVE. WAKEFIELD, RI 02879 USA |
| Name | Role | Address |
|---|---|---|
| NOAH BENEDICT | SECRETARY | 100 KENYON AVE. WAKEFIELD, RI 02879 USA |
| Name | Role | Address |
|---|---|---|
| SANDY COLETTA | DIRECTOR | 100 KENYON AVE. WAKEFIELD, RI 02879 USA |
| ROBERT DYER | DIRECTOR | 100 KENYON AVE. WAKEFIELD, RI 02879 USA |
| JOHN HOWLAND | DIRECTOR | 100 KENYON AVE. WAKEFIELD, RI 02879 USA |
| ROGEAN MAKOWSKI | DIRECTOR | 100 KENYON AVE. WAKEFIELD, RI 02879 USA |
| RICK NORBERG | DIRECTOR | 100 KENYON AVE. WAKEFIELD, RI 02879 USA |
| JOSEPH F. MATTHEWS | DIRECTOR | 100 KENYON AVE. WAKEFIELD, RI 02879 USA |
| VICTORIA WICKS | DIRECTOR | 100 KENYON AVENUE WAKEFIELD, RI 02879 USA |
| JASON MARSHALL | DIRECTOR | 100 KENYON AVE. WAKEFIELD, RI 02879 USA |
| AUSTIN SMITH | DIRECTOR | 100 KENYON AVE. WAKEFIELD, RI 02879 USA |
| BARBARA WOLFE | DIRECTOR | 100 KENYON AVE. WAKEFIELD, RI 02879 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Merged | 2000-05-08 | South County Health Care Corporation | South County Hospital Healthcare System |
| Name Change | 1999-06-10 | South County Hospital, Inc. | South County Hospital Healthcare System |
| Number | Name | File Date |
|---|---|---|
| 202445048720 | Annual Report | 2024-01-30 |
| 202338569190 | Annual Report | 2023-06-21 |
| 202338455790 | Revocation Notice For Failure to File An Annual Report | 2023-06-20 |
| 202220598200 | Annual Report | 2022-06-28 |
| 202220507400 | Revocation Notice For Failure to File An Annual Report | 2022-06-28 |
| 202198648060 | Annual Report | 2021-06-24 |
| 202197305270 | Fictitious Business Name Statement | 2021-06-01 |
| 202041538580 | Annual Report | 2020-06-04 |
| 202036620210 | Statement of Change of Registered/Resident Agent | 2020-03-20 |
| 201994888410 | Annual Report | 2019-05-29 |
Date of last update: 07 Oct 2024
Sources: Rhode Island Department of State
