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FAIRLAWN PRIMARY CARE, INC.

Company Details

Name: FAIRLAWN PRIMARY CARE, INC.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 12 Mar 2004 (21 years ago)
Identification Number: 000138661
ZIP code: 02860
County: Providence County
Purpose: PROVIDING MEDICAL SERVICES
Principal Address: Google Maps Logo 966 MINERAL SPRING AVENUE, PAWTUCKET, RI, 02860, 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

PRESIDENT

Name Role Address
FADI MANSOURATI MD PRESIDENT 966 MINERAL SPRING AVENUE PAWTUCKET, RI 02860 USA

Agent

Name Role Address
JAMES A. BRIDEN, ESQ. Agent 17 HOLLOW RIDGE ROAD, RUMFORD, RI, 02916, USA

National Provider Identifier

NPI Number:
1508898909

Authorized Person:

Name:
MS. HOLLY FERNANDES
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
No

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
200861787
Plan Year:
2023
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
5
Sponsors Telephone Number:

Filings

Number Name File Date
202446765770 Annual Report 2024-02-16
202339761340 Statement of Change of Registered/Resident Agent Office 2023-07-25
202329882570 Annual Report 2023-03-01
202216834620 Annual Report 2022-04-28
202198416920 Annual Report 2021-06-17

Uniform Commercial Code

The Uniform Commercial Code (UCC) is a comprehensive set of laws governing all commercial transactions in the United States.

A UCC filing is a public notice of a secured transaction. A financing statement indicates a commercial agreement between a debtor and a secured party.

Uniform Commercial Code Summary

Type:
UCC-3 CONTINUATION
UCC Filing Number:
Filing Date:
2025-04-15
Action:
Continuation

Parties

Party Name:
FAIRLAWN PRIMARY CARE, INC.
Party Role:
Debtor(s)

Uniform Commercial Code Summary

Type:
UCC-1 Standard
UCC Filing Number:
Filing Date:
2020-09-11
Action:
InitialFiling

Parties

Party Name:
FAIRLAWN PRIMARY CARE, INC.
Party Role:
Debtor(s)
Party Name:
CITIZENS BANK, N.A.
Party Role:
Secured Parties

USAspending Awards / Financial Assistance

Date:
2020-04-30
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
6000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-16
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
67800.00
Total Face Value Of Loan:
67800.00

Paycheck Protection Program

Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
67800
Current Approval Amount:
67800
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Unanswered
Veteran:
Non-Veteran
Forgiveness Amount:
68269.96

Date of last update: 21 May 2025

Sources: Rhode Island Department of State