| Name: | ARA-TIVERTON DIALYSIS LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 28 Jul 2004 (20 years ago) |
| Identification Number: | 000141955 |
| ZIP code: | 02878 |
| County: | Newport County |
| Place of Formation: | DELAWARE |
| Principal Address: | 500 CUMMINGS CENTER SUITE 6550, BEVERLY, MA, 01915, USA |
| Mailing Address: | 22 HURST LANE, TIVERTON, RI, 02878, USA |
| Purpose: | ESTABLISHING, OWNING AND OPERATING ONE OR MORE OUTPATIENT RENAL DIALYSIS FACILITIES OR ANY OTHER BUSINESS PURPOSE PERMITTED BY LAW. |
| NAICS: | 621492 - Kidney Dialysis Centers |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285745570 | 2006-08-31 | 2023-01-11 | 22 HURST LN, TIVERTON, RI, 028782312, US | 22 HURST LN, TIVERTON, RI, 028782312, US | |||||||||||||||||||||||||||
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| Phone | +1 401-624-4403 |
| Fax | 4016244623 |
Authorized person
| Name | SARA ANNE BRADY |
| Role | CHIEF NURSING OFFICER |
| Phone | 2083717878 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1316354 |
| State | MA |
| Issuer | MEDICAID |
| Number | TD50961 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | 222 JEFFERSON BOULEVARD SUITE 200, WARWICK, RI, 02888, USA |
| Name | Role | Address |
|---|---|---|
| JOSEPH A. CHAZAN | MANAGER | 290 BLACKSTONE BLVD PROVIDENCE, RI 02906 USA |
| SYED T. KAMAL | MANAGER | 17925 CACHET ISLE DRIVE TAMPA, FL 33647 USA |
| NICK MENDEZ | MANAGER | 22 HURST LANE TIVERTON, RI 02878 USA |
| Number | Name | File Date |
|---|---|---|
| 202451802350 | Annual Report | 2024-04-22 |
| 202334124960 | Annual Report | 2023-04-26 |
| 202217499990 | Statement of Change of Registered/Resident Agent | 2022-05-19 |
| 202214659900 | Annual Report | 2022-04-13 |
| 202103221030 | Annual Report | 2021-10-14 |
| 202065035700 | Annual Report | 2020-10-15 |
| 201924370790 | Annual Report | 2019-10-16 |
| 201877893760 | Annual Report | 2018-09-20 |
| 201749872420 | Annual Report | 2017-09-18 |
| 201609477880 | Annual Report | 2016-09-27 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
