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  5. Gastroenterology Specialists, Inc.

Gastroenterology Specialists, Inc.

Company Details

Name: Gastroenterology Specialists, Inc.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Dissolved
Date of Organization in Rhode Island: 15 Dec 1997 (27 years ago)
Date of Dissolution: 02 Feb 2018 (7 years ago)
Date of Status Change: 02 Feb 2018 (7 years ago)
Identification Number: 000098099
ZIP code: 02891
County: Washington County
Principal Address: 45 WELLS STREET SUITE 103, WESTERLY, RI, 02891, USA
Purpose: RENDER MEDICAL SERVICES SPECAILIZING IN GASTROENTEROLOGY
NAICS: 62 - Health Care and Social Assistance

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1780782706 2006-09-21 2013-01-22 45 WELLS ST, SUITE 103, WESTERLY, RI, 028912927, US 45 WELLS ST, SUITE 103, WESTERLY, RI, 028912927, US

Contacts
Phone +1 401-596-6330
Fax 4013480420

Authorized person
Name MRS. DEBORAH GERVASINI
Role OFFICE MANAGER
Phone 4015966330

Taxonomy
Taxonomy Code 207RG0100X - Gastroenterology Physician
Is Primary Yes
Taxonomy Code 363L00000X - Nurse Practitioner
Is Primary No

Other Provider Identifiers
Issuer MEDICAID
Number 003104130
State CT
Issuer MEDICAID
Number GS24547
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GASTROENTEROLOGY SPECIALISTS, INC. 401(K) PROFIT SHARING PLAN 2015 050495855 2016-12-29 GASTROENTEROLOGY SPECIALISTS, INC. 20
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-01-01
Business code 621111
Sponsor’s telephone number 4015966330
Plan sponsor’s address 45 WELLS STREET, SUITE 103, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2016-12-28
Name of individual signing BRADFORD LAVIGNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-12-28
Name of individual signing BRADFORD LAVIGNE
Valid signature Filed with authorized/valid electronic signature
GASTROENTEROLOGY SPECIALISTS, INC. 401(K) PROFIT SHARING PLAN 2015 050495855 2016-07-15 GASTROENTEROLOGY SPECIALISTS, INC. 22
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-01-01
Business code 621111
Sponsor’s telephone number 4015966330
Plan sponsor’s address 45 WELLS STREET, SUITE 103, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2016-07-14
Name of individual signing BRADFORD LAVIGNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-14
Name of individual signing BRADFORD LAVIGNE
Valid signature Filed with authorized/valid electronic signature
GASTROENTEROLOGY SPECIALISTS, INC. 401(K) PROFIT SHARING PLAN 2014 050495855 2015-06-23 GASTROENTEROLOGY SPECIALISTS, INC. 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-01-01
Business code 621111
Sponsor’s telephone number 4015966330
Plan sponsor’s address 45 WELLS STREET, SUITE 103, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2015-06-22
Name of individual signing BRADFORD LAVIGNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-06-22
Name of individual signing BRADFORD LAVIGNE
Valid signature Filed with authorized/valid electronic signature
GASTROENTEROLOGY SPECIALISTS, INC. 401(K) PROFIT SHARING PLAN 2013 050495855 2014-07-23 GASTROENTEROLOGY SPECIALISTS, INC. 27
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-01-01
Business code 621111
Sponsor’s telephone number 4015966330
Plan sponsor’s address 45 WELLS STREET, SUITE 103, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2014-07-22
Name of individual signing BRADFORD LAVIGNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-22
Name of individual signing BRADFORD LAVIGNE
Valid signature Filed with authorized/valid electronic signature
GASTROENTEROLOGY SPECIALISTS, INC. 401(K) PROFIT SHARING PLAN 2012 050495855 2013-07-11 GASTROENTEROLOGY SPECIALISTS, INC. 26
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-01-01
Business code 621111
Sponsor’s telephone number 4015966330
Plan sponsor’s address 45 WELLS STREET, SUITE 103, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2013-07-11
Name of individual signing BRADFORD LAVIGNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-11
Name of individual signing BRADFORD LAVIGNE
Valid signature Filed with authorized/valid electronic signature
GASTROENTEROLOGY SPECIALISTS, INC. 401(K) PROFIT SHARING PLAN 2011 050495855 2012-06-06 GASTROENTEROLOGY SPECIALISTS, INC. 28
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-01-01
Business code 621111
Sponsor’s telephone number 4015966330
Plan sponsor’s address 45 WELLS STREET, SUITE 103, WESTERLY, RI, 02891

Plan administrator’s name and address
Administrator’s EIN 050495855
Plan administrator’s name GASTROENTEROLOGY SPECIALISTS, INC.
Plan administrator’s address 45 WELLS STREET, SUITE 103, WESTERLY, RI, 02891
Administrator’s telephone number 4015966330

Signature of
Role Plan administrator
Date 2012-06-06
Name of individual signing BRADFORD C LAVIGNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-06-06
Name of individual signing BRADFORD C LAVIGNE
Valid signature Filed with authorized/valid electronic signature
GASTROENTEROLOGY SPECIALISTS, INC. PROFIT SHARING PLAN 2010 050495855 2011-05-17 GASTROENTEROLOGY SPECIALISTS, INC. 26
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-01-01
Business code 621111
Sponsor’s telephone number 4015966330
Plan sponsor’s address 45 WELLS STREET, SUITE 103, WESTERLY, RI, 02891

Plan administrator’s name and address
Administrator’s EIN 050495855
Plan administrator’s name GASTROENTEROLOGY SPECIALISTS, INC.
Plan administrator’s address 45 WELLS STREET, SUITE 103, WESTERLY, RI, 02891
Administrator’s telephone number 4015966330

Signature of
Role Plan administrator
Date 2011-05-16
Name of individual signing BRADFORD C LAVIGNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-05-16
Name of individual signing BRADFORD C LAVIGNE
Valid signature Filed with authorized/valid electronic signature
GASTROENTEROLOGY SPECIALISTS, INC. PROFIT SHARING PLAN 2009 050495855 2010-07-20 GASTROENTEROLOGY SPECIALISTS, INC. 25
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-01-01
Business code 621111
Sponsor’s telephone number 4015966330
Plan sponsor’s address 45 WELLS STREET, SUITE 103, WESTERLY, RI, 02891

Plan administrator’s name and address
Administrator’s EIN 050495855
Plan administrator’s name GASTROENTEROLOGY SPECIALISTS, INC.
Plan administrator’s address 45 WELLS STREET, SUITE 103, WESTERLY, RI, 02891
Administrator’s telephone number 4015966330

Signature of
Role Plan administrator
Date 2010-07-19
Name of individual signing BRADFORD LAVIGNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-19
Name of individual signing BRADFORD LAVIGNE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ROBERT M. DUFFY, ESQ. Agent ONE FINANCIAL PLAZA SUITE 1800, PROVIDENCE, RI, 02903, USA

PRESIDENT

Name Role Address
BRADFORD C. LAVIGNE M.D. PRESIDENT 45 WELLS STREET, SUITE 103 WESTERLY, RI 02891 USA

TREASURER

Name Role Address
STEVEN R. YOLEN M.D. TREASURER 45 WELLS STREET, SUITE 103 WESTERLY, RI 02891 USA

SECRETARY

Name Role Address
STEVEN R. YOLEN M.D. SECRETARY 45 WELLS STREET, SUITE 103 WESTERLY, RI 02891 USA

DIRECTOR

Name Role Address
BRADFORD C. LAVIGNE M.D. DIRECTOR 45 WELLS STREET, SUITE 103 WESTERLY, RI 02891 USA
STEVEN R. YOLEN M.D. DIRECTOR 45 WELLS STREET, SUITE 103 WESTERLY, RI 02891 USA

Filings

Number Name File Date
201857440320 Articles of Dissolution 2018-02-02
201735010720 Annual Report 2017-02-28
201692075680 Annual Report 2016-02-08
201556058790 Annual Report 2015-03-02
201435855360 Annual Report 2014-02-20
201435854930 Statement of Change of Registered/Resident Agent 2014-02-20
201314265400 Annual Report 2013-03-21
201290975760 Annual Report 2012-03-15
201174874840 Annual Report 2011-02-14
201060101340 Annual Report 2010-03-10

Related by officers

ROBERT M. DUFFY, ESQ.

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Related by address

No related companies by address

Date of last update: 08 Oct 2024

Sources: Rhode Island Department of State

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