| Name: | Jean Plover, M.D. Family Practice, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 01 Jul 2002 (23 years ago) |
| Date of Dissolution: | 12 Sep 2023 (a year ago) |
| Date of Status Change: | 12 Sep 2023 (a year ago) |
| Identification Number: | 000125650 |
| ZIP code: | 02905 |
| County: | Providence County |
| Principal Address: | 1660 BROAD STREET, CRANSTON, RI, 02905, USA |
| Purpose: | RENDERING PROFESSIONAL MEDICAL HEALTH CARE SERVICES |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619183407 | 2007-05-16 | 2012-12-20 | 1660 BROAD ST, CRANSTON, RI, 029052730, US | 1660 BROAD ST, CRANSTON, RI, 029052730, US | |||||||||||||||||||
|
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| Phone | +1 401-784-8281 |
| Fax | 4017848285 |
Authorized person
| Name | JEAN PLOVER |
| Role | PHYSICIAN OWNER |
| Phone | 4017848281 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | MD08149 |
| State | RI |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ALAN R. TATE ESQ. | Agent | 40 WESTMINSTER STREET, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| JEAN PLOVER MD | PRESIDENT | 1660 BROAD STREET CRANSTON, RI 02905- USA |
| Number | Name | File Date |
|---|---|---|
| 202341472250 | Revocation Certificate For Failure to File the Annual Report for the Year | 2023-09-12 |
| 202338058630 | Revocation Notice For Failure to File An Annual Report | 2023-06-19 |
| 202209330780 | Annual Report | 2022-02-03 |
| 202191697290 | Annual Report | 2021-02-17 |
| 202066953030 | Annual Report | 2020-10-21 |
| 202055021580 | Revocation Notice For Failure to File An Annual Report | 2020-09-16 |
| 201989251500 | Annual Report | 2019-03-26 |
| 201985751950 | Statement of Change of Registered Office by the Registered Agent | 2019-02-01 |
| 201860262890 | Annual Report | 2018-03-12 |
| 201738111370 | Annual Report | 2017-03-15 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
