| Name: | Coventry Primary Care Associates, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 24 May 2002 (23 years 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) |
| 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 | |||||||||||||||||||
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| 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 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2020-07-14 |
| Name of individual signing | KELLY MANOWN |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| JOHN W. WOLFE, ESQ. | Agent | CAMERON & MITTLEMAN LLP 301 PROMENADE STREET, PROVIDENCE, RI, 02908, USA |
| 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 |
| 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 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
