| 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 (7 years ago) |
| Date of Status Change: | 31 Aug 2018 (7 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)This U.S. industry comprises establishments of health practitioners having the degree of M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathy) primarily engaged in the independent practice of general or specialized medicine (except psychiatry or psychoanalysis) or surgery. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. Learn more at the U.S. Census Bureau
| 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 | |||||||||||||||||
|
|||||||||||||||||||||
| 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: 09 Apr 2025
Sources: Rhode Island Department of State
