| Name: | Coventry Primary Care Associates, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 24 May 2002 (23 years ago) |
| Date of Dissolution: | 04 Dec 2024 (4 months ago) |
| Date of Status Change: | 04 Dec 2024 (4 months ago) |
| Identification Number: | 000125008 |
| ZIP code: | 02816 |
| County: | Kent County |
| Principal Address: | 1620 NOOSENECK HILL ROAD, COVENTRY, RI, 02816, USA |
| Purpose: | TO RENDER PROFESSIONAL MEDICAL SERVICES BY PHYSICIANS SPECIALIZING IN INTERNAL MEDICINE AND DULY LICENSED TO PRACTICE MEDICINE IN THE STATE OF RHODE ISLAND |
NAICS
621111 Offices of Physicians (except Mental Health Specialists)This U.S. industry comprises establishments of health practitioners having the degree of M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathy) primarily engaged in the independent practice of general or specialized medicine (except psychiatry or psychoanalysis) or surgery. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508906330 | 2007-02-08 | 2012-10-22 | 5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA, 921211705, US | 1620 NOOSENECK HILL RD, COVENTRY, RI, 028166705, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 858-625-2990 |
| Phone | +1 401-821-6981 |
Authorized person
| Name | KENNY HEINE |
| Role | DIRECTOR OF OPERATIONS |
| Phone | 8586252990 |
Taxonomy
| Taxonomy Code | 332900000X - Non-Pharmacy Dispensing Site |
| License Number | MD10397 |
| State | RI |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COVENTRY PRIMARY CARE ASSOCIATES 401(K) PROFIT SHARING PLAN & TRU | 2019 | 010709308 | 2020-07-14 | COVENTRY PRIMARY CARE ASSOCIATES | 7 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2020-07-14 |
| Name of individual signing | KELLY MANOWN |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| TIMOTHY MANOWN MD | PRESIDENT | 1620 NOOSENECK HILL ROAD COVENTRY, RI 02816 USA |
| Name | Role | Address |
|---|---|---|
| DONALD B. HEBB, III, MD | TREASURER | 1620 NOOSENECK HILL ROAD COVENTRY, RI 02816 USA |
| Name | Role | Address |
|---|---|---|
| DONALD B. HEBB, III, MD | SECRETARY | 1620 NOOSENECK HILL ROAD COVENTRY, RI 02816 USA |
| Name | Role | Address |
|---|---|---|
| DONALD B. HEBB III, MD | VICE PRESIDENT | 1620 NOOSENECK HILL ROAD COVENTRY, RI 02816 USA |
| Name | Role | Address |
|---|---|---|
| TIMOTHY MANOWN MD | DIRECTOR | 1620 NOOSENECK HILL ROAD COVENTRY, RI 02816 USA |
| DONALD B. HEBB III, MD | DIRECTOR | 1620 NOOSENECK HILL ROAD COVENTRY, RI 02816 USA |
| Name | Role | Address |
|---|---|---|
| JOHN W. WOLFE, ESQ. | Agent | CAMERON & MITTLEMAN LLP 301 PROMENADE STREET, PROVIDENCE, RI, 02908, USA |
| Number | Name | File Date |
|---|---|---|
| 202453967110 | Annual Report | 2024-05-07 |
| 202329487360 | Annual Report | 2023-02-28 |
| 202214401770 | Annual Report | 2022-04-11 |
| 202207780280 | Statement of Change of Registered/Resident Agent | 2022-01-10 |
| 202190644330 | Annual Report | 2021-02-10 |
| 202034678150 | Annual Report | 2020-02-19 |
| 201987296530 | Annual Report | 2019-02-22 |
| 201859350050 | Annual Report | 2018-02-28 |
| 201734558430 | Annual Report | 2017-02-22 |
| 201692869630 | Annual Report | 2016-02-23 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 8277357309 | 2020-05-01 | 0165 | PPP | 1620 NOOSENECK HILL RD, COVENTRY, RI, 02816-6705 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Date of last update: 10 Apr 2025
Sources: Rhode Island Department of State
