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  5. GEORGE D. BERTHERMAN, O.D., INC.

GEORGE D. BERTHERMAN, O.D., INC.

Company Details

Name: GEORGE D. BERTHERMAN, O.D., INC.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 10 Apr 1995 (30 years ago)
Identification Number: 000084309
ZIP code: 02905
County: Providence County
Principal Address: 1466 BROAD STREET, PROVIDENCE, RI, 02905, USA
Purpose: TO OPERATE AN OPTOMETRIST'S OFFICE.
NAICS: 621320 - Offices of Optometrists
Historical names: HARRY E. PASS, O.D., INC.
Drs. Pass & Bertherman, Inc.

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1316072143 2007-02-22 2022-09-30 1466 BROAD ST, PROVIDENCE, RI, 029052836, US 1466 BROAD ST, PROVIDENCE, RI, 029052836, US

Contacts
Phone +1 401-941-6221
Fax 4019416227

Authorized person
Name GEORGE D BERTHERMAN
Role PRESIDENT
Phone 4019416221

Taxonomy
Taxonomy Code 152W00000X - Optometrist
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 1316072
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GEORGE D. BERTHERMAN, O.D., INC. 401(K) PLAN 2023 050486393 2024-04-09 GEORGE D. BERTHERMAN, O.D., INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 4019416221
Plan sponsor’s address 1466 BROAD STEET, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2024-04-09
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-04-09
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
GEORGE D. BERTHERMAN, O.D., INC. 401(K) PLAN 2022 050486393 2023-03-28 GEORGE D. BERTHERMAN, O.D., INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 4019416221
Plan sponsor’s address 1466 BROAD STEET, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2023-03-28
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-03-28
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
GEORGE D. BERTHERMAN, O.D., INC. 401(K) PLAN 2021 050486393 2022-04-02 GEORGE D. BERTHERMAN, O.D., INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 4019416221
Plan sponsor’s address 1466 BROAD STEET, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2022-04-02
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-04-02
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
GEORGE D. BERTHERMAN, O.D., INC. 401(K) PLAN 2020 050486393 2021-04-28 GEORGE D. BERTHERMAN, O.D., INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 4019416221
Plan sponsor’s address 1466 BROAD STEET, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2021-04-28
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-28
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
GEORGE D. BERTHERMAN, O.D., INC. 401(K) PLAN 2019 050486393 2020-04-06 GEORGE D. BERTHERMAN, O.D., INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 4019416221
Plan sponsor’s address 1466 BROAD STEET, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2020-04-06
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-04-06
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
GEORGE D. BERTHERMAN, O.D., INC. 401(K) PLAN 2018 050486393 2019-03-11 GEORGE D. BERTHERMAN, O.D., INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 4019416221
Plan sponsor’s address 1466 BROAD STEET, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2019-03-11
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-03-11
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
GEORGE D. BERTHERMAN, O.D., INC. 401(K) PLAN 2017 050486393 2018-01-19 GEORGE D. BERTHERMAN, O.D., INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 4019416221
Plan sponsor’s address 1466 BROAD STEET, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2018-01-19
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-01-19
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
GEORGE D. BERTHERMAN, O.D., INC. 401(K) PLAN 2016 050486393 2017-02-28 GEORGE D. BERTHERMAN, O.D., INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 4019416221
Plan sponsor’s address 1466 BROAD STEET, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2017-02-28
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-02-28
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
GEORGE D. BERTHERMAN, O.D., INC. 401(K) PLAN 2015 050486393 2016-03-16 GEORGE D. BERTHERMAN, O.D., INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 4019416221
Plan sponsor’s address 1466 BROAD STEET, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2016-03-16
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-03-16
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
GEORGE D. BERTHERMAN, O.D., INC. 401(K) PLAN 2014 050486393 2015-04-27 GEORGE D. BERTHERMAN, O.D., INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 4019416221
Plan sponsor’s address 1466 BROAD STEET, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2015-04-27
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-04-27
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/03/31/20140331154634P040095714629001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 4019416221
Plan sponsor’s address 1466 BROAD STEET, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2014-03-31
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-03-31
Name of individual signing GEORGE BERTHERMAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
STEPHEN M. RAPPOPORT Agent 989 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914, USA

PRESIDENT

Name Role Address
GEORGE BERTHERMAN PRESIDENT 1466 BROAD STREET PROVIDENCE, RI 02905 USA

Events

Type Date Old Value New Value
Name Change 2013-11-26 Drs. Pass & Bertherman, Inc. GEORGE D. BERTHERMAN, O.D., INC.
Name Change 2000-09-01 HARRY E. PASS, O.D., INC. Drs. Pass & Bertherman, Inc.

Filings

Number Name File Date
202446620240 Annual Report 2024-02-12
202327326300 Annual Report 2023-02-01
202217256250 Annual Report 2022-05-06
202193069950 Annual Report 2021-02-24
201930861910 Annual Report 2019-12-30
201883467610 Annual Report 2018-12-31
201755290450 Annual Report 2017-12-21
201730515950 Annual Report 2017-01-19
201589910320 Annual Report 2015-12-30
201451391370 Annual Report 2014-12-18

Related by officers

STEPHEN M. RAPPOPORT

AMERICAN LAWN SPRINKLER CO. CARI-LI, INC. J.P. Smith & Son, Inc. NATHAN KAUFMAN CO., INC. Weiner Genie, Inc. Cal-Scott Enterprises, Inc. H, D & B Refreshments Incorporated Reliable Cleaning Inc. R.P. RAPPOPORT, INC. ON THE RAIL, INC.

GEORGE BERTHERMAN

Pass & Bertherman Management Co., Inc.

Related by address

1466 BROAD STREET, PROVIDENCE, RI, 02905, USA

Pass & Bertherman Management Co., Inc.

Date of last update: 08 Oct 2024

Sources: Rhode Island Department of State

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