| Name: | HILLSIDE AVENUE FAMILY AND COMMUNITY MEDICINE, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 29 Oct 2003 (21 years ago) |
| Date of Dissolution: | 10 Dec 2018 (6 years ago) |
| Date of Status Change: | 10 Dec 2018 (6 years ago) |
| Identification Number: | 000135644 |
| ZIP code: | 02860 |
| County: | Providence County |
| Principal Address: | 727 EAST AVENUE, PAWTUCKET, RI, 02860, USA |
| Purpose: | TO ENGAGE IN THE PRACTICE OF FAMILY AND COMMUNITY MEDICINE |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447392469 | 2007-02-13 | 2012-10-17 | 5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA, 921211705, US | 727 EAST AVE, PAWTUCKET, RI, 028606184, US | |||||||||||||||||
|
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| Phone | +1 401-724-6160 |
Authorized person
| Name | KENNY HEINE |
| Role | DIRECTOR OF OPERATIONS |
| Phone | 8586252990 |
Taxonomy
| Taxonomy Code | 332900000X - Non-Pharmacy Dispensing Site |
| License Number | MD06978 |
| State | RI |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CARL I. FREEDMAN, ESQ. | Agent | ONE PARK ROW SUITE 300, PROVIDENCE, RI, 02903, USA |
| Number | Name | File Date |
|---|---|---|
| 201882474060 | Articles of Dissolution | 2018-12-10 |
| 201879779800 | Annual Report | 2018-10-19 |
| 201753289050 | Annual Report | 2017-11-13 |
| 201610303400 | Annual Report | 2016-10-13 |
| 201588923150 | Annual Report | 2015-12-07 |
| 201446867350 | Annual Report | 2014-09-29 |
| 201328775100 | Annual Report | 2013-09-25 |
| 201202521070 | Annual Report | 2012-11-05 |
| 201183186860 | Annual Report | 2011-09-19 |
| 201067452210 | Annual Report | 2010-09-21 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
