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  5. Imaging Network of Rhode Island, Inc.

Imaging Network of Rhode Island, Inc.

Company Details

Name: Imaging Network of Rhode Island, Inc.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Dissolved
Date of Organization in Rhode Island: 05 Dec 1994 (30 years ago)
Date of Dissolution: 31 Dec 2015 (9 years ago)
Date of Status Change: 31 Dec 2015 (9 years ago)
Identification Number: 000082039
ZIP code: 02908
County: Providence County
Principal Address: 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908, USA
Purpose: TO RENDER PROFESSIONAL MEDICAL SERVICES TO THE GENERAL PUBLIC INCLUDING THE PRACTICE OF RADIOLOGY AND DIAGNOSTIC IMAGING.
Fictitious names: North Scituate Radiology, Inc. (trading name, 1997-09-02 - )

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1689657249 2005-11-28 2009-11-17 PO BOX 9132, BROOKLINE, MA, 024469132, US 825 CHALKSTONE AVE, ROGERS WILLIAMS MEDICAL CENTER, PROVIDENCE, RI, 029084728, US

Contacts
Phone +1 603-893-9784
Fax 6038938886
Phone +1 401-456-2204

Authorized person
Name DR. BRIAN STAINKEN
Role DELEGATE
Phone 4013342423

Taxonomy
Taxonomy Code 2085R0202X - Diagnostic Radiology Physician
Is Primary Yes

Other Provider Identifiers
Issuer BLUE SHIELD
Number 2627-9
State RI
Issuer MEDICAID
Number 9002627
State RI
Issuer MEDICAID
Number 9775617
State MA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
IMAGING NETWORK OF RHODE ISLAND, INC. 401(K) PLAN 2015 050480516 2016-06-27 IMAGING NETWORK OF RHODE ISLAND, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621510
Sponsor’s telephone number 4014562204
Plan sponsor’s address 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908

Plan administrator’s name and address
Administrator’s EIN 050480516
Plan administrator’s name IMAGING NETWORK OF RHODE ISLAND, INC.
Plan administrator’s address 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908
Administrator’s telephone number 4014562204
IMAGING NETWORK OF RHODE ISLAND, INC. 401(K) PLAN 2015 050480516 2016-12-12 IMAGING NETWORK OF RHODE ISLAND, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621510
Sponsor’s telephone number 4014562204
Plan sponsor’s address 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908
IMAGING NETWORK OF RHODE ISLAND, INC. 401(K) PLAN 2014 050480516 2015-07-16 IMAGING NETWORK OF RHODE ISLAND, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621510
Sponsor’s telephone number 4014562204
Plan sponsor’s address 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908

Plan administrator’s name and address
Administrator’s EIN 050480516
Plan administrator’s name IMAGING NETWORK OF RHODE ISLAND, INC.
Plan administrator’s address 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908
Administrator’s telephone number 4014562204

Signature of
Role Plan administrator
Date 2015-07-16
Name of individual signing GARY MARECEK
Valid signature Filed with authorized/valid electronic signature
IMAGING NETWORK OF RHODE ISLAND, INC. 401(K) PLAN 2013 050480516 2014-05-27 IMAGING NETWORK OF RHODE ISLAND, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621510
Sponsor’s telephone number 4014562204
Plan sponsor’s address 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908

Plan administrator’s name and address
Administrator’s EIN 050480516
Plan administrator’s name IMAGING NETWORK OF RHODE ISLAND, INC.
Plan administrator’s address 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908
Administrator’s telephone number 4014562204

Signature of
Role Plan administrator
Date 2014-05-27
Name of individual signing GARY MARECEK
Valid signature Filed with authorized/valid electronic signature
IMAGING NETWORK OF RHODE ISLAND, INC. 401(K) PLAN 2012 050480516 2013-09-25 IMAGING NETWORK OF RHODE ISLAND, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621510
Sponsor’s telephone number 4014562204
Plan sponsor’s address 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908

Plan administrator’s name and address
Administrator’s EIN 050480516
Plan administrator’s name IMAGING NETWORK OF RHODE ISLAND, INC.
Plan administrator’s address 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908
Administrator’s telephone number 4014562204

Signature of
Role Plan administrator
Date 2013-09-25
Name of individual signing GARY MARECEK
Valid signature Filed with authorized/valid electronic signature
IMAGING NETWORK OF RHODE ISLAND, INC. 401(K) PLAN 2011 050480516 2012-10-10 IMAGING NETWORK OF RHODE ISLAND, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621510
Sponsor’s telephone number 4014562204
Plan sponsor’s address 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908

Plan administrator’s name and address
Administrator’s EIN 050480516
Plan administrator’s name IMAGING NETWORK OF RHODE ISLAND, INC.
Plan administrator’s address 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908
Administrator’s telephone number 4014562204

Signature of
Role Plan administrator
Date 2012-10-10
Name of individual signing GARY MARECEK
Valid signature Filed with authorized/valid electronic signature
IMAGING NETWORK OF RHODE ISLAND, INC. 401(K) PLAN 2010 050480516 2011-10-07 IMAGING NETWORK OF RHODE ISLAND, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621510
Sponsor’s telephone number 4014562204
Plan sponsor’s address 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908

Plan administrator’s name and address
Administrator’s EIN 050480516
Plan administrator’s name IMAGING NETWORK OF RHODE ISLAND, INC.
Plan administrator’s address 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908
Administrator’s telephone number 4014562204

Signature of
Role Plan administrator
Date 2011-10-07
Name of individual signing GARY MARECEK
Valid signature Filed with authorized/valid electronic signature
IMAGING NETWORK OF RHODE ISLAND, INC. 401(K) PLAN 2009 050480516 2010-10-08 IMAGING NETWORK OF RHODE ISLAND, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621510
Sponsor’s telephone number 4014562204
Plan sponsor’s address 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908

Plan administrator’s name and address
Administrator’s EIN 050480516
Plan administrator’s name IMAGING NETWORK OF RHODE ISLAND, INC.
Plan administrator’s address 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908
Administrator’s telephone number 4014562204

Signature of
Role Plan administrator
Date 2010-10-08
Name of individual signing GARY MARECEK
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
STEVEN I. ROSENBAUM, ESQ. Agent POORE & ROSENBAUM LLP 30 EXCHANGE TERRACE, PROVIDENCE, RI, 02903, USA

PRESIDENT

Name Role Address
BRIAN STAINKEN MD PRESIDENT 825 CHALKSTONE AVENUE PROVIDENCE, RI 02908 USA

Filings

Number Name File Date
201589896930 Articles of Dissolution 2015-12-31
201554966970 Annual Report 2015-02-12
201435517240 Annual Report 2014-02-12
201311700940 Annual Report 2013-02-15
201288812880 Annual Report 2012-01-30
201174401910 Annual Report 2011-02-02
201057169030 Annual Report 2010-01-20
200940760150 Annual Report 2009-01-20
200806050500 Annual Report 2008-01-22

Related by officers

STEVEN I. ROSENBAUM, ESQ.

ANDRADE AUTO BODY, INC. SVEN A. BENSON & SONS, INC. CHERRY TREE, LTD. Coken Company, Inc. Surdut Eye Associates, Inc. CREATIVE ENAMELING, INC. TRAFFIC ENGINEERING and SALES,INC. HCC Marketing Inc Rhode Island Tile Distributors, Inc. SHEFFIELD ASSOCIATES, INC.

Related by address

825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908, USA

Rosebank Corporation RWGH Physicians Office Building, Inc. Roger Williams Medical Center Elmhurst Extended Care Facilities, Inc. Roger Williams Realty Corporation ELMHURST HEALTH ASSOCIATES, INC. Roger Williams PHO, Inc. Roger Williams Medical Associates, Inc. University Medical Group, Inc.

Date of last update: 07 Oct 2024

Sources: Rhode Island Department of State

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