Name: | Valley Primary Care, Inc. |
Jurisdiction: | Rhode Island |
Entity type: | Domestic Profit Corporation |
Status: | Revoked Entity |
Date of Organization in Rhode Island: | 17 Oct 2001 (23 years ago) |
Date of Dissolution: | 28 Aug 2013 (11 years ago) |
Date of Status Change: | 28 Aug 2013 (11 years ago) |
Identification Number: | 000120814 |
ZIP code: | 02842 |
County: | Newport County |
Principal Address: | 294 VALLEY ROAD, MIDDLETOWN, RI, 02842, USA |
Purpose: | TO ENGAGE IN THE GENERAL PRACTICE OF MEDICINE |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1104048396 | 2007-05-03 | 2008-06-19 | 294 VALLEY ROAD, MIDDLETOWN, RI, 02842, US | 294 VALLEY ROAD, MIDDLETOWN, RI, 02842, US | |||||||||||||||||||||||||
|
Phone | +1 401-847-7772 |
Fax | 4018464959 |
Authorized person
Name | DR. PAUL V DEL GUERCIO |
Role | PHYSICIAN OWNER |
Phone | 4018477772 |
Taxonomy
Taxonomy Code | 207Q00000X - Family Medicine Physician |
License Number | MD07423 |
State | RI |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 9020091 |
State | RI |
Name | Role | Address |
---|---|---|
PAUL DELGUERCIO, MD | Agent | 294 VALLEY ROAD, MIDDLETOWN, RI, 02842, USA |
Name | Role | Address |
---|---|---|
PAUL DELGUERCIO MD | PRESIDENT | 3 KAY STREET NEWPORT, RI 02840- USA |
Name | Role | Address |
---|---|---|
MARIANNE F DELGUERCIO | VICE PRESIDENT | 3 KAY STREET NEWPORT, RI 02840 USA |
Number | Name | File Date |
---|---|---|
201327281080 | Revocation Certificate For Failure to File the Annual Report for the Year | 2013-08-28 |
201321883820 | Revocation Notice For Failure to File An Annual Report | 2013-06-03 |
201295441260 | Annual Report | 2012-07-30 |
201293093010 | Revocation Notice For Failure to File An Annual Report | 2012-05-23 |
201176201040 | Annual Report | 2011-03-05 |
201057946640 | Annual Report | 2010-02-04 |
200940660360 | Annual Report | 2009-01-22 |
200808359610 | Annual Report | 2008-03-19 |
200700675250 | Annual Report | 2007-09-19 |
200701503020 | Revocation Notice For Failure to File An Annual Report | 2007-08-09 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State