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South County Family Medicine, Inc.

Company Details

Name: South County Family Medicine, Inc.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Revoked Entity
Date of Organization in Rhode Island: 28 Mar 2001 (24 years ago)
Date of Dissolution: 28 Aug 2013 (12 years ago)
Date of Status Change: 28 Aug 2013 (12 years ago)
Identification Number: 000117563
ZIP code: 02818
County: Kent County
Purpose: TO PROVIDE MEDICAL SERVICES TO PATIENTS
Principal Address: Google Maps Logo 3461 SOUTH COUNTY TRAIL SUITE 202, EAST GREENWICH, RI, 02818, USA

Agent

Name Role Address
JEFFREY F. CHASE-LUBITZ, ESQ. Agent DONOGHUE BARRETT & SINGAL PC 10 WEYBOSSET STREET, PROVIDENCE, RI, 02903, USA

PRESIDENT

Name Role Address
JONATHAN BERTMAN, M.D. PRESIDENT 3461 SOUTH COUNTY TRAIL, SUITE 202 EAST GREENWICH, RI 02818 USA

National Provider Identifier

NPI Number:
1225041064

Authorized Person:

Name:
DR. JONATHAN BERTMAN
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
4015396741

Form 5500 Series

Employer Identification Number (EIN):
050516401
Plan Year:
2013
Number Of Participants:
58
Sponsors DBA Name:
SOUTH COUNTY FAMILY MEDICINE
Sponsors Telephone Number:

Filings

Number Name File Date
201327278710 Revocation Certificate For Failure to File the Annual Report for the Year 2013-08-28
201321878790 Revocation Notice For Failure to File An Annual Report 2013-06-03
201289686110 Annual Report 2012-02-14
201176222900 Annual Report 2011-03-02
201059958010 Annual Report 2010-03-03

Date of last update: 20 May 2025

Sources: Rhode Island Department of State