| 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 |
| Fictitious names: |
Aquidneck Hearing Center (trading name, 2009-01-28 - ) |
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
| 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 | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| 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 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 8285417107 | 2020-04-15 | 0165 | PPP | 850 Aquidneck Avenue Unit B-9, Middletown, RI, 02842 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
