| Name: | Physicians of Rhode Island Medical Enterprises, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 14 Mar 2000 (25 years ago) |
| Identification Number: | 000111374 |
| ZIP code: | 02865 |
| County: | Providence County |
| Principal Address: | 8 CHRISTOPHER DRIVE, LINCOLN, RI, 02865, USA |
| Purpose: | MEDICAL CONSULTING |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| Fictitious names: |
Body Evolution Wellness, Longevity & Weight Loss Centers (trading name, 2011-07-21 - ) A Way To Wellness (trading name, 2004-05-25 - ) Spa Doctors (trading name, 2004-04-23 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063402964 | 2005-10-24 | 2011-02-07 | PO BOX 27, MANVILLE, RI, 028380027, US | 106 NATE WHIPPLE HWY, SUITE 101 CUMBERLAND MEDICAL CENTER, CUMBERLAND, RI, 028641403, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 800-927-0002 |
| Fax | 6038901236 |
| Phone | +1 401-658-2020 |
| Fax | 4016583612 |
Authorized person
| Name | SCOTT WILSON |
| Role | PRESIDENT |
| Phone | 4016582020 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PR32677 |
| State | RI |
| Issuer | TUFTS |
| Number | 685836 |
| State | MA |
| Name | Role | Address |
|---|---|---|
| STEPHEN D. ZUBIAGO, ESQ. | Agent | NIXON PEABODY LLP ONE CITIZENS PLAZA SUITE 500, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| SCOTT WILSON M.D. | PRESIDENT | 8 CHRISTOPHER DRIVE LINCOLN, RI 02865 USA |
| Name | Role | Address |
|---|---|---|
| SCOTT WILSON M.D. | TREASURER | 8 CHRISTOPHER DRIVE LINCOLN, RI 02865 USA |
| Name | Role | Address |
|---|---|---|
| SCOTT WILSON M.D. | SECRETARY | 8 CHRISTOPHER DRIVE LINCOLN, RI 02865 USA |
| Number | Name | File Date |
|---|---|---|
| 202447512300 | Annual Report | 2024-02-29 |
| 202329687300 | Annual Report | 2023-03-01 |
| 202213281580 | Annual Report | 2022-03-23 |
| 202191275290 | Annual Report | 2021-02-15 |
| 202034900800 | Annual Report | 2020-02-21 |
| 201987332030 | Annual Report | 2019-02-22 |
| 201861020110 | Annual Report | 2018-03-26 |
| 201749219180 | Annual Report | 2017-09-05 |
| 201747758960 | Revocation Notice For Failure to File An Annual Report | 2017-07-27 |
| 201694172990 | Annual Report | 2016-03-11 |
Date of last update: 08 Oct 2024
Sources: Rhode Island Department of State
