| 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)This U.S. industry comprises establishments of health practitioners having the degree of M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathy) primarily engaged in the independent practice of general or specialized medicine (except psychiatry or psychoanalysis) or surgery. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. Learn more at the U.S. Census Bureau
| 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: 11 Apr 2025
Sources: Rhode Island Department of State
