| Name: | CHEPACHET PHARMACY, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 02 Jul 1990 (35 years ago) |
| Date of Dissolution: | 28 Dec 2012 (12 years ago) |
| Date of Status Change: | 28 Dec 2012 (12 years ago) |
| Identification Number: | 000061261 |
| ZIP code: | 02830 |
| County: | Providence County |
| Principal Address: | 405 LAPHAM FARM ROAD P.O. BOX 346, HARRISVILLE, RI, 02830, USA |
| Purpose: | PHARMACY |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184731879 | 2006-08-25 | 2020-08-22 | PO BOX 702, 15 MONEY HILL RD, CHEPACHET, RI, 028140901, US | 15 MONEY HILL RD, CHEPACHET, RI, 028140901, US | |||||||||||||||||||||||||||||||
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| Phone | +1 401-568-2536 |
| Fax | 4015682563 |
Authorized person
| Name | DR. CRAIG A BOWEN |
| Role | PHARMACIST IN CHARGE |
| Phone | 4015682536 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PHA00115 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NABP PROVIDER NUMBER |
| Number | 4100501 |
| State | RI |
| Issuer | MEDICAID |
| Number | 9010115 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| CRAIG A. BOWEN | Agent | 405 LAPHAM FARM ROAD P.O. BOX 346, HARRISVILLE, RI, 02830, USA |
| Name | Role | Address |
|---|---|---|
| CRAIG BOWEN | PRESIDENT | P.O. BOX 346 HARRISVILLE, RI 02830 |
| Number | Name | File Date |
|---|---|---|
| 201206678950 | Articles of Dissolution | 2012-12-28 |
| 201289254030 | Annual Report | 2012-02-09 |
| 201174757080 | Annual Report | 2011-02-10 |
| 201058380740 | Annual Report | 2010-02-11 |
| 201057660780 | Statement of Change of Registered/Resident Agent | 2010-02-02 |
| 201056126700 | Revocation Notice For Failure to Maintain a Registered Office | 2010-01-12 |
| 201056123880 | Registered Office Not Maintained | 2010-01-04 |
| 200943290870 | Annual Report | 2009-02-26 |
| 200805871610 | Annual Report | 2008-01-17 |
Date of last update: 07 Oct 2024
Sources: Rhode Island Department of State
