| Name: | Mineral Spring Primary Care Associates, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 19 Mar 2003 (22 years ago) |
| Date of Dissolution: | 27 Jun 2017 (8 years ago) |
| Date of Status Change: | 27 Jun 2017 (8 years ago) |
| Identification Number: | 000130658 |
| ZIP code: | 02904 |
| County: | Providence County |
| Principal Address: | 1637 MINERAL SPRING AVENUE SUITE 111, NORTH PROVIDENCE, RI, 02904, USA |
| Purpose: | PROVIDING PRIMARY MEDICAL CARE SERVICES TO PATIENTS |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801848908 | 2006-05-17 | 2014-09-08 | 1637 MINERAL SPRING AVE, SUITE 111, NORTH PROVIDENCE, RI, 029044042, US | 1637 MINERAL SPRING AVE, SUITE 111, NORTH PROVIDENCE, RI, 029044042, US | |||||||||||||||
|
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| Phone | +1 401-353-5224 |
| Fax | 4013535162 |
Authorized person
| Name | CATHY L POISSON |
| Role | PRACTICE ADMINISTRATOR |
| Phone | 4013531012 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JOSEPH J RODIO SR | Agent | RODIO & URSILLO LTD 86 WEYBOSSET STREET SUITE 400, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| MICHAEL ROCCHIO MD | MANAGER | 1637 MINERAL SPRING AVENUE NORTH PROVIDENCE, RI 02904 USA |
| Number | Name | File Date |
|---|---|---|
| 201746264840 | Revocation Certificate For Failure to File the Annual Report for the Year | 2017-06-27 |
| 201739817370 | Revocation Notice For Failure to File An Annual Report | 2017-04-06 |
| 201581545070 | Annual Report | 2015-10-05 |
| 201449016340 | Annual Report | 2014-10-29 |
| 201328065210 | Annual Report | 2013-09-11 |
| 201296309190 | Annual Report | 2012-08-22 |
| 201181781940 | Annual Report | 2011-09-01 |
| 201178117510 | Statement of Change of Registered/Resident Agent | 2011-04-22 |
| 201072282170 | Annual Report | 2010-11-16 |
| 200952282080 | Annual Report | 2009-10-06 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
