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EMERGENCY MEDICINE PHYSICIANS OF PROVIDENCE COUNTY, LLC

Company Details

Name: EMERGENCY MEDICINE PHYSICIANS OF PROVIDENCE COUNTY, LLC
Jurisdiction: Rhode Island
Entity type: Domestic Limited Liability Company
Status: Revoked Entity
Date of Organization in Rhode Island: 18 Nov 2003 (22 years ago)
Date of Dissolution: 14 Feb 2022 (3 years ago)
Date of Status Change: 14 Feb 2022 (3 years ago)
Identification Number: 000136152
Purpose: EMERGENCY PHYSICIAN STAFFING
Principal Address: Google Maps Logo 4535 DRESSLER ROAD NW, CANTON, OH, 44718, USA

Industry & Business Activity

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

Agent

Name Role Address
CORPORATION SERVICE COMPANY Agent 222 JEFFERSON BOULEVARD SUITE 200, WARWICK, RI, 02888, USA

MANAGER

Name Role Address
USACS MANAGEMENT GROUP, LTD MANAGER 4535 DRESSLER ROAD CANTON, OH 44718 USA

National Provider Identifier

NPI Number:
1194764019

Authorized Person:

Name:
DAVID C PACKO
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207P00000X - Emergency Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
3304938677

Filings

Number Name File Date
202210220230 Revocation Certificate For Failure to File the Annual Report for the Year 2022-02-14
202106681930 Revocation Notice For Failure to File An Annual Report 2021-12-03
202067517330 Annual Report 2020-10-22
201925902710 Annual Report 2019-10-29
201876977650 Annual Report 2018-09-10

Date of last update: 21 May 2025

Sources: Rhode Island Department of State