| Name: | EAR NOSE & THROAT MEDICINE AND SURGERY GROUP, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 14 May 2004 (21 years ago) |
| Identification Number: | 000140227 |
| ZIP code: | 02842 |
| County: | Newport County |
| Principal Address: | 850 AQUIDNECK AVENUE UNIT B-9, MIDDLETOWN, RI, 02842, USA |
| Mailing Address: | 850 AQUIDNECK AVENUE, MIDDLETOWN, RI, 02842, USA |
| Purpose: | PHYSICIAN MEDICAL SERVICES OFFICE |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| Fictitious names: |
Aquidneck Hearing Center (trading name, 2009-01-28 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1689772287 | 2006-09-20 | 2015-05-01 | 850 AQUIDNECK AVE, MIDDLETOWN, RI, 028427244, US | 850 AQUIDNECK AVE, MIDDLETOWN, RI, 028427244, US | |||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 401-849-4448 |
| Fax | 4018496479 |
Authorized person
| Name | MRS. DEBORAH A MURPHY |
| Role | OFFICE MANAGER |
| Phone | 4018494448 |
Taxonomy
| Taxonomy Code | 207Y00000X - Otolaryngology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | TUFTS |
| Number | 739270 |
| State | RI |
| Issuer | MEDICAID |
| Number | EN11261 |
| State | RI |
| Issuer | MEDICAID |
| Number | 9000136 |
| State | RI |
| Issuer | NEIGHBORHOOD HEALTH PLAN |
| Number | 0334 |
| State | RI |
| Issuer | RAILROAD MEDICARE |
| Number | CA0758 |
| State | RI |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 0000002519 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| LINN F. FREEDMAN, ESQ. | Agent | ROBINSON & COLE LLP ONE FINANCIAL PLAZA SUITE 1430, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| STEVEN F FREEDMAN MD | MANAGER | 850 AQUIDNECK AVENUE MIDDLETOWN , RI 02842 USA |
| Number | Name | File Date |
|---|---|---|
| 202445704400 | Annual Report | 2024-02-06 |
| 202327157300 | Annual Report | 2023-02-01 |
| 202210042210 | Annual Report | 2022-02-10 |
| 202103429300 | Annual Report | 2021-10-19 |
| 202194831790 | Annual Report | 2021-03-23 |
| 202194446750 | Revocation Notice For Failure to File An Annual Report | 2021-03-16 |
| 201914564480 | Annual Report | 2019-08-22 |
| 201876292410 | Annual Report | 2018-08-30 |
| 201749185430 | Annual Report | 2017-09-05 |
| 201609173070 | Annual Report | 2016-09-22 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
