| Name: | Pelton Family Chiropractic Center, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 27 Apr 1993 (32 years ago) |
| Identification Number: | 000072323 |
| ZIP code: | 02879 |
| County: | Washington County |
| Principal Address: | 730 KINGSTOWN ROAD SUITE 3, WAKEFIELD, RI, 02879, USA |
| Purpose: | CHIROPRACTIC MEDICINE |
| NAICS: | 621310 - Offices of Chiropractors |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740361419 | 2006-10-18 | 2020-08-22 | 730 KINGSTOWN RD STE 3, WAKEFIELD, RI, 028793002, US | 730 KINGSTOWN RD STE 3, WAKEFIELD, RI, 028793002, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 401-782-8380 |
| Fax | 4017823650 |
Authorized person
| Name | DR. CHRISTINE LYNN PELTON |
| Role | VICE PRESIDENT |
| Phone | 4017828380 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | DC323 |
| State | RI |
| Is Primary | Yes |
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | DC332 |
| State | RI |
| Is Primary | No |
Other Provider Identifiers
| Issuer | UHC -DR. CHRISTINE PELTON |
| Number | 44-00020 |
| State | RI |
| Issuer | UHC -DR. KEVIN PELTON |
| Number | 44-00023 |
| State | RI |
| Issuer | BLUE CROSS BLUE SHIELD RI |
| Number | 9145-5 |
| State | RI |
| Issuer | MEDICAID |
| Number | 000323 |
| State | RI |
| Issuer | MEDICAID |
| Number | 000332 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| KEVIN J. PELTON | Agent | 730 KINGSTOWN ROAD SUITE 3, WAKEFIELD, RI, 02879, USA |
| Name | Role | Address |
|---|---|---|
| KEVIN J PELTON | PRESIDENT | 380A POST ROAD WAKEFIELD, RI 02879 USA |
| Name | Role | Address |
|---|---|---|
| CHRISTINE L PELTON | VICE PRESIDENT | 380A POST ROAD WAKEFIELD, RI 02879 USA |
| Number | Name | File Date |
|---|---|---|
| 202455126740 | Annual Report | 2024-05-31 |
| 202332879150 | Annual Report | 2023-04-12 |
| 202215535960 | Annual Report | 2022-04-18 |
| 202193510290 | Annual Report | 2021-03-01 |
| 202034957570 | Annual Report | 2020-02-24 |
| 201986418870 | Annual Report | 2019-02-11 |
| 201859550540 | Annual Report | 2018-02-28 |
| 201735096210 | Annual Report | 2017-02-27 |
| 201693439760 | Annual Report | 2016-02-29 |
| 201556122950 | Annual Report | 2015-03-02 |
Date of last update: 07 Oct 2024
Sources: Rhode Island Department of State
