| Name: | Everest Healthcare Rhode Island, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 08 Dec 2000 (24 years ago) |
| Identification Number: | 000115704 |
| Place of Formation: | DELAWARE |
| Principal Address: | 920 WINTER ST., WALTHAM, MA, 02451, USA |
| Purpose: | DIALYSIS SERVICES |
| NAICS: | 621492 - Kidney Dialysis Centers |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639188345 | 2006-08-05 | 2023-10-14 | 2814 POST RD, WARWICK, RI, 028863169, US | 2814 POST RD, WARWICK, RI, 028863169, US | |||||||||||||||||||||
|
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| Phone | +1 401-738-4050 |
| Fax | 4017387298 |
Authorized person
| Name | BARRY L. BLANTON |
| Role | VICE PRESIDENT |
| Phone | 7816999000 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 4125010 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 450 VETERANS MEMORIAL PARKWAY SUITE 7A, EAST PROVIDENCE, RI, 02914, USA |
| Name | Role | Address |
|---|---|---|
| CRAIG CORDOLA | PRESIDENT | 920 WINTER ST. WALTHAM , MA 02451 USA |
| Name | Role | Address |
|---|---|---|
| KAREN GLEDHILL | SECRETARY | 920 WINTER ST. WALTHAM , MA 02451 USA |
| Name | Role | Address |
|---|---|---|
| DENNIS BRAUN | CFO | 920 WINTER ST. WALTHAM , MA 02451 USA |
| Name | Role | Address |
|---|---|---|
| DOMENIC GAETA | ASSISTANT SECRETARY | 920 WINTER ST. WALTHAM , MA 02451 USA |
| JULIE HAWKINS | ASSISTANT SECRETARY | 920 WINTER ST. WALTHAM , MA 02451 USA |
| Name | Role | Address |
|---|---|---|
| RYAN VALLE | VICE PRESIDENT | 920 WINTER ST. WALTHAM , MA 02451 USA |
| Name | Role | Address |
|---|---|---|
| BRYAN MELLO | ASSISTANT TREASURER | 920 WINTER ST. WALTHAM , MA 02451 USA |
| MOLLIE MILLER | ASSISTANT TREASURER | 920 WINTER ST. WALTHAM , MA 02451 USA |
| DOROTHY RIZZO | ASSISTANT TREASURER | 920 WINTER ST. WALTHAM , MA 02451 USA |
| Name | Role | Address |
|---|---|---|
| KAREN GLEDHILL | SENIOR VICE PRESIDENT | 920 WINTER ST. WALTHAM , MA 02451 USA |
| Name | Role | Address |
|---|---|---|
| CRAIG CORDOLA | DIRECTOR | 920 WINTER ST. WALTHAM , MA 02451 USA |
| Number | Name | File Date |
|---|---|---|
| 202451030410 | Annual Report | 2024-04-15 |
| 202331911590 | Annual Report | 2023-03-28 |
| 202215881580 | Annual Report | 2022-04-27 |
| 202193167980 | Annual Report | 2021-02-26 |
| 202035491910 | Annual Report | 2020-02-28 |
| 201987285020 | Annual Report | 2019-02-22 |
| 201858077020 | Annual Report | 2018-02-12 |
| 201734892660 | Annual Report | 2017-02-27 |
| 201692834070 | Annual Report | 2016-02-22 |
| 201555733850 | Annual Report | 2015-02-25 |
Date of last update: 08 Oct 2024
Sources: Rhode Island Department of State
