| Name: | Ocean Medical Practice, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 15 Jul 2004 (21 years ago) |
| Identification Number: | 000141469 |
| ZIP code: | 02895 |
| County: | Providence County |
| Principal Address: | 20 CUMBERLAND ROAD, WOONSOCKET, RI, 02895, USA |
| Purpose: | TO ENGAGE IN THE PRACTICE OF MEDICINE |
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 | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043401979 | 2007-08-06 | 2008-04-01 | 20 CUMBERLAND HILL RD, SUITE 208, WOONSOCKET, RI, 028954854, US | 20 CUMBERLAND HILL RD, SUITE 208, WOONSOCKET, RI, 028954854, US | |||||||||||||||||||||||||
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| Phone | +1 401-765-1200 |
| Fax | 4017651212 |
Authorized person
| Name | DR. JIBRAN KHAN |
| Role | PRESIDENT |
| Phone | 4017651200 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | 9516 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | OM69208 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| STEPHEN D. ZUBIAGO, ESQ. | Agent | NIXON PEABODY LLP ONE CITIZENS PLAZA SUITE 500, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| JIBRAN KHAN MD | PRESIDENT | 20 CUMBERLAND HILL ROAD WOONSOCKET, RI 02895- USA |
| Number | Name | File Date |
|---|---|---|
| 202449749100 | Annual Report | 2024-03-28 |
| 202332323040 | Annual Report | 2023-04-03 |
| 202217191100 | Annual Report | 2022-05-02 |
| 202193500660 | Annual Report | 2021-03-01 |
| 202035167040 | Annual Report | 2020-02-24 |
| 201988900210 | Annual Report | 2019-03-18 |
| 201860806760 | Annual Report | 2018-03-22 |
| 201737394990 | Annual Report | 2017-03-03 |
| 201692590020 | Annual Report | 2016-02-16 |
| 201556752760 | Annual Report | 2015-03-09 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 8226597104 | 2020-04-15 | 0165 | PPP | 20 Cumberland Hill Road Suite 208, Cumberland, RI, 02895 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
