| Name: | CRAWFORD FAMILY MEDICINE, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 07 Apr 1995 (30 years ago) |
| Identification Number: | 000083762 |
| ZIP code: | 02857 |
| County: | Providence County |
| Principal Address: | P.O. BOX 428, SCITUATE, RI, 02857, USA |
| Purpose: | RENDERING PROFESSIONAL SERVICES AS PHYSICIANS. |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013173319 | 2008-08-06 | 2008-09-05 | 33 DANIELSON PIKE, NORTH SCITUATE, RI, 028571877, US | 33 DANIELSON PIKE, NORTH SCITUATE, RI, 028571877, US | |||||||||||||||||||||||||
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| Phone | +1 410-647-7411 |
| Fax | 4016472840 |
Authorized person
| Name | DR. KIM JAY CRAWFORD |
| Role | PRESIDENT |
| Phone | 4016477411 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | MD07139 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 9020220 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| SCOTT T. SPEAR, ESQ. | Agent | BLISH & CAVANAGH 30 EXCHANGE TERRACE, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| KIM J. CRAWFORD | PRESIDENT | P.O. BOX 428 SCITUATE, RI 02857 USA |
| Number | Name | File Date |
|---|---|---|
| 202448474850 | Annual Report | 2024-03-12 |
| 202331295780 | Annual Report | 2023-03-15 |
| 202210969670 | Annual Report | 2022-02-14 |
| 202192074360 | Annual Report | 2021-02-18 |
| 202033621300 | Annual Report | 2020-02-03 |
| 201984578350 | Annual Report | 2019-01-16 |
| 201857310470 | Annual Report | 2018-01-29 |
| 201731175180 | Annual Report | 2017-01-30 |
| 201691160170 | Annual Report | 2016-01-22 |
| 201553823670 | Annual Report | 2015-01-16 |
Date of last update: 07 Oct 2024
Sources: Rhode Island Department of State
