| Name: | Atlantic Professional Services of Rhode Island, Incorporated |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 29 Mar 2004 (21 years ago) |
| Identification Number: | 000139042 |
| Principal Address: | 307 S. EVERGREEN AVE. SUITE 101, WOODBURY, NJ, 08096, USA |
| Purpose: | THE RENDERING OF PROFESSIONAL PHYSICIAN SERVICES |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | Atlantic Professional Services of Rhode Island, Incorporated, NEW YORK | 3362014 | NEW YORK |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922036946 | 2006-06-29 | 2020-09-28 | PO BOX 635998, CINCINNATI, OH, 452635998, US | 100 KENYON AVENUE, WAKEFIELD, RI, 028794299, US | |||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 401-782-8000 |
Authorized person
| Name | DR. DAVID ISTVAN |
| Role | DIRECTOR |
| Phone | 5188421900 |
Taxonomy
| Taxonomy Code | 208M00000X - Hospitalist Physician |
| Is Primary | Yes |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICARE TRAVELERS RR - G |
| Number | DC9415 |
| State | RI |
| Issuer | MEDICAID |
| Number | 02821543 |
| State | NY |
| Issuer | MEDICAID |
| Number | 7003615 |
| State | RI |
| Issuer | MEDICAID |
| Number | 1018847630001 |
| State | PA |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | 222 JEFFERSON BOULEVARD SUITE 200, WARWICK, RI, 02888, USA |
| Name | Role | Address |
|---|---|---|
| STEPHEN MURTAUGH | TREASURER/SECRETARY | 307 S EVERGREEN AVE, SUITE 101 WOODBURY, NJ 08096 USA |
| Name | Role | Address |
|---|---|---|
| LARA OWENS | ASSISTANT TREASURER | 265 BROOKVIEW CENTRE WAY, STE 400 KNOXVILLE, TN 37919 USA |
| JOHN BARRACK | ASSISTANT TREASURER | 265 BROOKVIEW CENTRE WAY, SUITE 400 KNOXVILLE, TN 37919 USA |
| Name | Role | Address |
|---|---|---|
| EUGENE JOHNSON | VICE PRESIDENT | 307 S. EVERGREEN AVE., SUITE 101 WOODBURY, NJ 08096 USA |
| Name | Role | Address |
|---|---|---|
| DAVID ISTVAN MD | DIRECTOR` | 307 S. EVERGREEN AVE., SUITE 101 WOODBURY, NJ 08096 USA |
| Name | Role | Address |
|---|---|---|
| DAVID ISTVAN MD | PRESIDENT | 307 S. EVERGREEN AVE., SUITE 101 WOOIDBURY, NJ 08096 USA |
| Name | Role | Address |
|---|---|---|
| JOHN R STAIR | ASSISTANT SECRETARY | 265 BROOKVIEW CENTRE WAY, SUITE 400 KNOXVILLE, TN 37919 USA |
| Number | Name | File Date |
|---|---|---|
| 202446350570 | Annual Report | 2024-02-14 |
| 202333054510 | Annual Report | 2023-04-17 |
| 202214770560 | Annual Report | 2022-04-14 |
| 202193338560 | Annual Report | 2021-03-01 |
| 202034979680 | Annual Report | 2020-02-24 |
| 201986944450 | Annual Report | 2019-02-19 |
| 201858781710 | Annual Report | 2018-02-22 |
| 201734243930 | Annual Report | 2017-02-16 |
| 201692486530 | Annual Report | 2016-02-16 |
| 201554841790 | Annual Report | 2015-02-10 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
