| Name: | University Medical Group, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 23 Apr 1997 (28 years ago) |
| Date of Dissolution: | 31 Aug 2018 (6 years ago) |
| Date of Status Change: | 31 Aug 2018 (6 years ago) |
| Identification Number: | 000094883 |
| ZIP code: | 02908 |
| County: | Providence County |
| Principal Address: | 825 CHALKSTONE AVENUE, PROVIDENCE, RI, 02908, USA |
| Purpose: | TO PROVIDE MEDICAL SERVICES TO THE SICK AND INJURED WHO MAY COME FOR DIAGNOSIS, TREATMENT AND CARE WITHOUT REGARD TO RACE. |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285775205 | 2007-02-11 | 2012-10-17 | 5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA, 921211705, US | 6 BLACKSTONE VALLEY PL, 502, LINCOLN, RI, 028651179, US | |||||||||||||||||
|
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| Phone | +1 401-334-6250 |
Authorized person
| Name | KENNY HEINE |
| Role | DIRECTOR OF OPERATIONS |
| Phone | 8586252990 |
Taxonomy
| Taxonomy Code | 332900000X - Non-Pharmacy Dispensing Site |
| License Number | MD09136 |
| State | RI |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JEFFREY F. CHASE-LUBITZ, ESQ. | Agent | DONOGHUE BARRETT & SINGAL P.C. ONE CEDAR STREET SUITE 300, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| AMER MALIK, M.D. | PRESIDENT | 825 CHALKSTONE AVENUE PROVIDENCE, RI 02908 USA |
| Name | Role | Address |
|---|---|---|
| GAYLE REBOVICH M.D. | TREASURER | 825 CHALKSTONE AVENUE PROVIDENCE, RI 02908 USA |
| Name | Role | Address |
|---|---|---|
| JOHN J. HOLIVER | DIRECTOR | 825 CHALKSTONE AVENUE PROVIDENCE, RI 02908 USA |
| VINCENT A. ARMENIO M.D. | DIRECTOR | 825 CHALKSTONE AVENUE PROVIDENCE, RI 02908 USA |
| AMER MALIK M.D. | DIRECTOR | 825 CHALKSTONE AVENUE PROVIDENCE, RI 02908 USA |
| Number | Name | File Date |
|---|---|---|
| 201876394970 | Articles of Dissolution | 2018-08-31 |
| 201870988300 | Annual Report | 2018-06-29 |
| 201746813390 | Annual Report | 2017-06-30 |
| 201601212560 | Annual Report | 2016-06-30 |
| 201563326330 | Annual Report | 2015-06-12 |
| 201561855210 | Statement of Change of Registered/Resident Agent Office | 2015-05-20 |
| 201561717400 | Revocation Notice For Failure to Maintain a Registered Office | 2015-05-13 |
| 201561623620 | Registered Office Not Maintained | 2015-05-04 |
| 201440856990 | Annual Report | 2014-06-12 |
| 201320335690 | Annual Report | 2013-05-09 |
Date of last update: 08 Oct 2024
Sources: Rhode Island Department of State
