| Name: | Associates in Anesthesia, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 21 Jul 1992 (33 years ago) |
| Date of Dissolution: | 23 Nov 2022 (2 years ago) |
| Date of Status Change: | 23 Nov 2022 (2 years ago) |
| Identification Number: | 000069026 |
| ZIP code: | 02904 |
| County: | Providence County |
| Principal Address: | 200 HIGH SERVICE AVENUE, NORTH PROVIDENCE, RI, 02904, USA |
| Purpose: | THE PRACTICE OF MEDICINE. |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| Fictitious names: |
St. Joseph Hospital School of Nurse Anesthesia (trading name, 2014-12-10 - 2021-08-31) ST. JOSEPH HOSPITAL SCHOOL OF ANESTHESIA FOR NURSES (trading name, 2014-03-04 - 2021-08-31) PRECISION PAIN TREATMENT CLINIC (trading name, 2014-03-04 - 2014-06-09) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235185679 | 2006-05-26 | 2013-06-14 | 200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI, 029045113, US | 200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI, 029045113, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 401-456-3136 |
| Fax | 4014563621 |
Authorized person
| Name | MS. CHERYL M GUGLIELMI |
| Role | PRACTICE MANAGER |
| Phone | 4014563136 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | Yes |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| License Number | MD07817 |
| State | RI |
| Is Primary | No |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| License Number | MD13812 |
| State | RI |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 9002571 |
| State | RI |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ASSOCIATES IN ANESTHESIA, INC. 401(K) PROFIT SHARING PLAN | 2018 | 050466669 | 2019-08-05 | ASSOCIATES IN ANESTHESIA, INC. | 6 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2019-08-05 |
| Name of individual signing | MICHELLE CONNOR |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 1985-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4014563139 |
| Plan sponsor’s address | 200 HIGH SERVICE AVENUE, NORTH PROVIDENCE, RI, 029045113 |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 1985-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4014563139 |
| Plan sponsor’s address | 200 HIGH SERVICE AVENUE, NORTH PROVIDENCE, RI, 029045113 |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 1985-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4014563139 |
| Plan sponsor’s address | 200 HIGH SERVICE AVENUE, NORTH PROVIDENCE, RI, 029045113 |
| Name | Role | Address |
|---|---|---|
| SUSAN LEACH DEBLASIO | Agent | ONE CITIZENS PLAZA 8TH FLOOR, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| JOHN D PRINSCOTT MD | PRESIDENT | 1 WEST EXCHANGE ST., STE. 2105 PROVIDENCE, RI 02903 USA |
| Name | Role | Address |
|---|---|---|
| STEVEN L MANCINI MD | TREASURER | 137 HIGH SERVICE AVENUE NORTH PROVIDENCE, RI 02911 USA |
| Name | Role | Address |
|---|---|---|
| STEVEN L MANCINI MD | SECRETARY | 137 HIGH SERVICE AVENUE NORTH PROVIDENCE, RI 02911 USA |
| Name | Role | Address |
|---|---|---|
| STEVEN LAWRENCE MANCINI MD | VICE PRESIDENT | 137 HIGH SERVICE AVENUE NORTH PROVIDENCE, RI 02911 USA |
| Number | Name | File Date |
|---|---|---|
| 202224850070 | Articles of Dissolution | 2022-11-23 |
| 202213092320 | Annual Report | 2022-03-18 |
| 202100545120 | Statement of Abandonment of Use of Fictitious Business Name | 2021-08-31 |
| 202100544790 | Statement of Abandonment of Use of Fictitious Business Name | 2021-08-31 |
| 202187871200 | Annual Report | 2021-01-26 |
| 202034119950 | Annual Report | 2020-02-11 |
| 201988394190 | Annual Report | 2019-03-11 |
| 201858826330 | Annual Report | 2018-02-22 |
| 201730382390 | Annual Report | 2017-01-17 |
| 201691851050 | Annual Report | 2016-02-03 |
Date of last update: 07 Oct 2024
Sources: Rhode Island Department of State
