| Name: | Brown Medicine |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 31 Dec 1999 (25 years ago) |
| Identification Number: | 000110369 |
| ZIP code: | 02903 |
| County: | Providence County |
| Principal Address: | 593 EDDY STREET, PROVIDENCE, RI, 02903, USA |
| Purpose: | ARTICLES OF CONSOLIDATION WERE FILED ON 12/31/1999 EFFECTIVE 01/01/2000 BETWEEN ID#8912 UNIVERSITY PHYSICIANS FOUNDATION, INC. AND ID#58536 RIH MEDICAL FOUNDATION INC FORMING ID#110369 UNIVERSITY MEDICINE FOUNDATION INC. ENGAGING IN THE PRACTICE OF MEDICINE FOR PATIENTS OF ANY HOSPITAL AFFILIATED WITH LIFESPAN CORPORATION AND ELSEWHERE. |
| NAICS: | 622310 - Specialty (except Psychiatric and Substance Abuse) Hospitals |
| Fictitious names: |
Brown Medicine Endoscopy Center (trading name, 2017-12-13 - ) University Medicine (trading name, 2011-07-28 - ) |
| Historical names: |
University Medicine Foundation, Inc. Brown Medicine |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467190496 | 2022-05-20 | 2024-01-18 | DEPT 3010, PO BOX 986524, BOSTON, MA, 022986524, US | 375 WAMPANOAG TRL, RIVERSIDE, RI, 029152232, US | |||||||||||||||||||||||||||
|
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| Phone | +1 401-443-4992 |
| Fax | 4015377241 |
| Phone | +1 401-649-4020 |
| Fax | 4016494021 |
Authorized person
| Name | DONNA GORDON |
| Role | RCM DIRECTOR |
| Phone | 4014435107 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | Yes |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | No |
| Taxonomy Code | 364SP0808X - Psychiatric/Mental Health Clinical Nurse Specialist |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| JOHN W. WOLFE, ESQ. | Agent | 301 PROMENADE STREET, PROVIDENCE, RI, 02908, USA |
| Name | Role | Address |
|---|---|---|
| LOUIS RICE MD | PRESIDENT | 593 EDDY STREET PROVIDENCE, RI 02903 USA |
| Name | Role | Address |
|---|---|---|
| PETER A. HOLLMANN MD | TREASURER | 593 EDDY STREET PROVIDENCE, RI 02903 USA |
| Name | Role | Address |
|---|---|---|
| PETER A. HOLLMANN MD | SECRETARY | 593 EDDY STREET PROVIDENCE, RI 02903 USA |
| Name | Role | Address |
|---|---|---|
| ANGELA CALIENDO MD | VICE PRESIDENT | 593 EDDY STREET PROVIDENCE, RI 02903 USA |
| Name | Role | Address |
|---|---|---|
| CHRISTINE DUFFY, MD | DIRECTOR | 593 EDDY STREET PROVIDENCE, RI 02903 USA |
| JOHN REAGAN, MD | DIRECTOR | 593 EDDY STREET PROVIDENCE, RI 02903 USA |
| C. JOY NASSAR MD | DIRECTOR | 593 EDDY STREET PROVIDENCE, RI 02903 USA |
| CHESTON CUNHA MD | DIRECTOR | 593 EDDY STREET PROVIDENCE, RI 02903 USA |
| NADIA MUJAHID MD | DIRECTOR | 593 EDDY STREET PROVIDENCE, RI 02903 USA |
| LOUIS RICE MD | DIRECTOR | 593 EDDY STREET PROVIDENCE, RI 02903 USA |
| KELLY MCGARRY , MD | DIRECTOR | 593 EDDY STREET PROVIDENCE, RI 02903 USA |
| THOMAS BLEDSOE , MD | DIRECTOR | 593 EDDY STREET PROVIDENCE, RI 02903 USA |
| HARLAN RICH , MD | DIRECTOR | 593 EDDY STREET PROVIDENCE, RI 02903 USA |
| COREY VENTETUOLO , MD | DIRECTOR | 593 EDDY STREET PROVIDENCE, RI 02903 USA |
| Name | Role | Address |
|---|---|---|
| ANN M. KASHMANIAN, CPA, MBA | CHIEF EXECUTIVE OFFICER | 593 EDDY STREET PROVIDENCE, RI 02903 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2018-02-01 | University Medicine Foundation, Inc. | Brown Medicine |
| Name Change | 2017-10-10 | Brown Medicine | University Medicine Foundation, Inc. |
| Name Change | 2017-10-03 | University Medicine Foundation, Inc. | Brown Medicine |
| Number | Name | File Date |
|---|---|---|
| 202446981440 | Annual Report | 2024-02-21 |
| 202330874490 | Annual Report | 2023-03-15 |
| 202215079130 | Annual Report | 2022-04-19 |
| 202207769410 | Statement of Change of Registered/Resident Agent | 2022-01-10 |
| 202198859060 | Annual Report | 2021-06-30 |
| 202044049010 | Annual Report | 2020-07-02 |
| 202037161910 | Statement of Change of Registered/Resident Agent | 2020-04-03 |
| 201905592430 | Annual Report | 2019-07-19 |
| 201872603940 | Annual Report | 2018-07-19 |
| 201856617110 | Articles of Amendment | 2018-01-23 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DEFINITIVE CONTRACT | AWARD | 36C24123C0042 | 2023-04-01 | 2024-03-31 | 2028-03-31 | |||||||||||||||||||||||||
|
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| Obligated Amount | 57773.00 |
| Current Award Amount | 57773.00 |
| Potential Award Amount | 254630.60 |
Description
| Title | SOLE SOURCE AFFILIATE ON-CALL GI PHYSICIAN SERVICES. |
| NAICS Code | 611310: COLLEGES, UNIVERSITIES, AND PROFESSIONAL SCHOOLS |
| Product and Service Codes | Q505: MEDICAL- GASTROENTEROLOGY |
Recipient Details
| Recipient | BROWN MEDICINE |
| UEI | NNFCJ56FXB98 |
| Recipient Address | UNITED STATES, 110 ELM ST, FL 2, PROVIDENCE, PROVIDENCE, RHODE ISLAND, 029034626 |
| Unique Award Key | CONT_AWD_36C24123C0012_3600_-NONE-_-NONE- |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 381048.75 |
| Current Award Amount | 381049.27 |
| Potential Award Amount | 1657214.03 |
Description
| Title | NEPHROLOGY PHYSICIAN SERVICES |
| NAICS Code | 611310: COLLEGES, UNIVERSITIES, AND PROFESSIONAL SCHOOLS |
| Product and Service Codes | Q999: MEDICAL- OTHER |
Recipient Details
| Recipient | BROWN MEDICINE |
| UEI | NNFCJ56FXB98 |
| Recipient Address | UNITED STATES, 110 ELM ST, FL 2, PROVIDENCE, PROVIDENCE, RHODE ISLAND, 029034626 |
Date of last update: 08 Oct 2024
Sources: Rhode Island Department of State
