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  5. ADVANCED EYE CARE ASSOCIATES, LLC.

ADVANCED EYE CARE ASSOCIATES, LLC.

Company Details

Name: ADVANCED EYE CARE ASSOCIATES, LLC.
Jurisdiction: Rhode Island
Entity type: Domestic Limited Liability Company
Status: Activ
Date of Organization in Rhode Island: 30 Dec 2004 (20 years ago)
Identification Number: 000144677
ZIP code: 02904
County: Providence County
Principal Address: 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904, USA
Purpose: OPTOMETRY PRACTICE
NAICS: 621320 - Offices of Optometrists

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1518973056 2006-08-01 2007-12-12 780 NORTH MAIN ST., PROVIDENCE, RI, 029045706, US 780 NORTH MAIN ST., PROVIDENCE, RI, 029045706, US

Contacts
Phone +1 401-331-2020
Fax 4013311179

Authorized person
Name DR. JOHN D CORROW
Role OWNER
Phone 4013312020

Taxonomy
Taxonomy Code 152W00000X - Optometrist
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 9003941
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AE 401K 2023 202076769 2024-10-10 ADVANCED EYE CARE ASSOCIATES, LLC 60
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2024-10-10
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
AE 401K 2022 202076769 2023-10-10 ADVANCED EYE CARE ASSOCIATES, LLC 60
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2023-10-10
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-10
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
AE 401K 2021 202076769 2022-07-08 ADVANCED EYE CARE ASSOCIATES, LLC 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2022-07-07
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-07-07
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
AE 401K 2020 202076769 2021-10-08 ADVANCED EYE CARE ASSOCIATES, LLC 50
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2021-10-08
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-08
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
AE 401K 2019 202076769 2020-10-13 ADVANCED EYE CARE ASSOCIATES, LLC 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2020-10-13
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-13
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
AE 401K 2018 202076769 2019-07-30 ADVANCED EYE CARE ASSOCIATES, LLC 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2019-07-30
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-30
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
AE 401K 2017 202076769 2018-09-09 ADVANCED EYE CARE ASSOCIATES, LLC 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2018-09-05
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-09-05
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
AE 401K 2016 202076769 2017-07-21 ADVANCED EYE CARE ASSOCIATES, LLC 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2017-07-19
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
AE CASH BALANCE PLAN 2015 202076769 2016-10-10 ADVANCED EYE CARE ASSOCIATES, LLC 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904
AE 401K 2015 202076769 2016-09-09 ADVANCED EYE CARE ASSOCIATES, LLC 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2016-08-24
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/10/09/20151009131520P040034851207001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2015-10-08
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/08/14/20150814160724P040010692369001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2015-08-14
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/09/12/20140912072710P040125445863001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2014-09-12
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/06/27/20140627105235P040414174403001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2014-06-25
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/16/20130716142942P030299813923001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2013-07-15
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/30/20120730133338P030001758420001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904

Plan administrator’s name and address
Administrator’s EIN 202076769
Plan administrator’s name ADVANCED EYE CARE ASSOCIATES, LLC
Plan administrator’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904
Administrator’s telephone number 4013312020

Signature of
Role Plan administrator
Date 2012-07-30
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/08/01/20110801142445P040015928498001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904

Plan administrator’s name and address
Administrator’s EIN 202076769
Plan administrator’s name ADVANCED EYE CARE ASSOCIATES, LLC
Plan administrator’s address 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904
Administrator’s telephone number 4013312020

Signature of
Role Plan administrator
Date 2011-08-01
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-21
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/23/20100723074125P040018360388001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 4013312020
Plan sponsor’s address 780NORTH MAIN STREET, PROVIDENCE, RI, 02904

Plan administrator’s name and address
Administrator’s EIN 202076769
Plan administrator’s name ADVANCED EYE CARE ASSOCIATES, LLC
Plan administrator’s address 780NORTH MAIN STREET, PROVIDENCE, RI, 02904
Administrator’s telephone number 4013312020

Signature of
Role Plan administrator
Date 2010-07-23
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-23
Name of individual signing JOHN CORROW
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CARL D. CORROW Agent 780 NORTH MAIN STREET, PROVIDENCE, RI, 02904, USA

Filings

Number Name File Date
202447371420 Annual Report 2024-02-27
202328689530 Annual Report 2023-02-17
202210013300 Annual Report 2022-02-10
202101011110 Annual Report 2021-09-07
202057102980 Annual Report 2020-09-22
201920118710 Annual Report 2019-09-17
201876592880 Annual Report 2018-09-04
201749190010 Annual Report 2017-09-05
201608383650 Annual Report 2016-09-06
201578504640 Annual Report 2015-09-08

Related by officers

CARL D. CORROW

VCC, LLC.

Related by address

780 NORTH MAIN STREET, PROVIDENCE, RI, 02904, USA

VCC, LLC.

Date of last update: 09 Oct 2024

Sources: Rhode Island Department of State

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