| 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) |
| 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 | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| 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 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
