Name: | ARA-JOHNSTON DIALYSIS LLC |
Jurisdiction: | Rhode Island |
Entity type: | Foreign Limited Liability Company |
Status: | Activ |
Date of Organization in Rhode Island: | 26 Sep 2003 (21 years ago) |
Identification Number: | 000135089 |
ZIP code: | 02919 |
County: | Providence County |
Place of Formation: | DELAWARE |
Principal Address: | 500 CUMMINGS CENTER SUITE 6550, BEVERLY, MA, 01915, USA |
Mailing Address: | 1526 ATWOOD AVENUE, JOHNSTON, RI, 02919, USA |
Purpose: | ESTABLISHING, OWNING AND OPERATING ONE OR MORE OUTPATIENT RENAL DIALYSIS FACILITIES OR ANY OTHER BUSINESS PURPOSE PERMITTED BY LAW. |
NAICS: | 621492 - Kidney Dialysis Centers |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1225147010 | 2006-08-29 | 2023-01-10 | 1526 ATWOOD AVE, JOHNSTON, RI, 029193289, US | 1526 ATWOOD AVE, JOHNSTON, RI, 029193289, US | |||||||||||||||||||||
|
Phone | +1 401-521-0400 |
Fax | 4015210403 |
Authorized person
Name | MRS. SARA ANNE BRADY |
Role | CHIEF NURSING OFFICER |
Phone | 2083717878 |
Taxonomy
Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | JD57725 |
State | RI |
Name | Role | Address |
---|---|---|
CORPORATION SERVICE COMPANY | Agent | 222 JEFFERSON BOULEVARD SUITE 200, WARWICK, RI, 02888, USA |
Name | Role | Address |
---|---|---|
JOSEPH A. CHAZAN M.D. | MANAGER | 290 BLACKSTONE BLVD PROVIDENCE, RI 02906 USA |
SYED T. KAMAL | MANAGER | 17925 CACHET ISLE DRIVE TAMPA, FL 33647 USA |
NICK MENDEZ | MANAGER | 1526 ATWOOD AVENUE JOHNSTON, RI 02919 USA |
Number | Name | File Date |
---|---|---|
202451812700 | Annual Report | 2024-04-22 |
202334115490 | Annual Report | 2023-04-26 |
202217499260 | Statement of Change of Registered/Resident Agent | 2022-05-19 |
202214724220 | Annual Report | 2022-04-14 |
202103221850 | Annual Report | 2021-10-14 |
202065206650 | Annual Report | 2020-10-16 |
201924371120 | Annual Report | 2019-10-16 |
201877735240 | Annual Report | 2018-09-18 |
201749848290 | Annual Report | 2017-09-18 |
201609487320 | Annual Report | 2016-09-27 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State