Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Providence County
    4. ›
  4. 02904
    5. ›
  5. PROVIDENCE UROLOGY, LLC

PROVIDENCE UROLOGY, LLC

Company Details

Name: PROVIDENCE UROLOGY, LLC
Jurisdiction: Rhode Island
Entity type: Domestic Limited Liability Company
Status: Dissolved
Date of Organization in Rhode Island: 27 Jan 2004 (21 years ago)
Date of Dissolution: 01 Dec 2017 (7 years ago)
Date of Status Change: 01 Dec 2017 (7 years ago)
Identification Number: 000137693
ZIP code: 02904
County: Providence County
Principal Address: 827 NORTH MAIN STREET SUITE 4, PROVIDENCE, RI, 02904, USA
Purpose: PROVIDE MEDICAL SERVICES SPECIALIZING IN UROLOGY
NAICS: 621399 - Offices of All Other Miscellaneous Health Practitioners

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1255386868 2006-05-23 2011-12-06 340 MAIN ST, STE. 670, WORCESTER, MA, 016081604, US 1165 N MAIN ST, SUITE 200, PROVIDENCE, RI, 029045740, US

Contacts
Phone +1 508-754-3566
Fax 5084386368
Phone +1 401-521-4333
Fax 4015214377

Authorized person
Name HARRY M IANNOTTI
Role PRESIDENT
Phone 4015214333

Taxonomy
Taxonomy Code 208800000X - Urology Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 9003351
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PROVIDENCE UROLOGY, LLC PROFIT SHARING PLAN 2018 200646820 2019-02-22 PROVIDENCE UROLOGY, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 4018617763
Plan sponsor’s address 1165 NORTH MAIN STREET, SUITE 200, PROVIDENCE, RI, 02904
PROVIDENCE UROLOGY, LLC PROFIT SHARING PLAN 2017 200646820 2018-03-28 PROVIDENCE UROLOGY, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 4018617763
Plan sponsor’s address 1165 NORTH MAIN STREET, SUITE 200, PROVIDENCE, RI, 02904
PROVIDENCE UROLOGY, LLC PROFIT SHARING PLAN 2016 200646820 2017-04-21 PROVIDENCE UROLOGY, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 4018617763
Plan sponsor’s address 1165 NORTH MAIN STREET, SUITE 200, PROVIDENCE, RI, 02904
PROVIDENCE UROLOGY, LLC PROFIT SHARING PLAN 2015 200646820 2016-07-19 PROVIDENCE UROLOGY, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 4018617763
Plan sponsor’s address 1165 NORTH MAIN STREET, SUITE 200, PROVIDENCE, RI, 02904
PROVIDENCE UROLOGY, LLC PROFIT SHARING PLAN 2014 200646820 2015-09-15 PROVIDENCE UROLOGY, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 4018617763
Plan sponsor’s address 1165 NORTH MAIN STREET, SUITE 200, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2015-09-15
Name of individual signing HARRY IANNOTTI
Valid signature Filed with authorized/valid electronic signature
PROVIDENCE UROLOGY, LLC PROFIT SHARING PLAN 2013 200646820 2014-07-28 PROVIDENCE UROLOGY, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 4018617763
Plan sponsor’s address 1165 NORTH MAIN STREET, SUITE 200, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2014-07-28
Name of individual signing HARRY IANNOTTI
Valid signature Filed with authorized/valid electronic signature
PROVIDENCE UROLOGY, LLC PROFIT SHARING PLAN 2012 200646820 2013-06-18 PROVIDENCE UROLOGY, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 4018617763
Plan sponsor’s address 1165 NORTH MAIN STREET, SUITE 200, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2013-06-18
Name of individual signing HARRY IANNOTTI
Valid signature Filed with authorized/valid electronic signature
PROVIDENCE UROLOGY, LLC PROFIT SHARING PLAN 2011 200646820 2012-10-12 PROVIDENCE UROLOGY, LLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 4018617763
Plan sponsor’s address 1165 NORTH MAIN STREET, SUITE 200, PROVIDENCE, RI, 02904

Plan administrator’s name and address
Administrator’s EIN 200646820
Plan administrator’s name PROVIDENCE UROLOGY, LLC
Plan administrator’s address 1165 NORTH MAIN STREET, SUITE 200, PROVIDENCE, RI, 02904
Administrator’s telephone number 4018617763

Signature of
Role Plan administrator
Date 2012-10-12
Name of individual signing HARRY IANNOTTI
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
E. COLBY CAMERON, ESQ. Agent 301 PROMENADE STREET, PROVIDENCE, RI, 02908, USA

Filings

Number Name File Date
201754411360 Articles of Dissolution 2017-12-01
201753073730 Annual Report 2017-11-07
201611861440 Annual Report 2016-11-08
201586496250 Annual Report 2015-10-29
201448993750 Annual Report 2014-10-28
201330669800 Annual Report 2013-11-14
201299433810 Annual Report 2012-10-15
201184249320 Annual Report 2011-10-18
201067473350 Annual Report 2010-09-21
200952829690 Annual Report 2009-10-20

Related by officers

E. COLBY CAMERON, ESQ.

AC Holdings, Inc. The Chisholm RIP Corp. CHOQUETTE & CO., INC. CHURCH TRAVEL AGENCY, INC. Certified Automotive, Inc. Memorial X-Ray Services, Ltd. Periodontics, Inc. D. L. Thurrott RIP, Inc. Sinel, Wilfand & Vinci, Certified Public Accountants, Inc. O'NEILL MEDICAL, INC.

Related by address

No related companies by address

Date of last update: 09 Oct 2024

Sources: Rhode Island Department of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 riorgs.com, Part of Big Data Integrated