| Name: | WELLNORTH MEDICAL LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 05 Apr 2005 (20 years ago) |
| Date of Dissolution: | 03 Dec 2019 (5 years ago) |
| Date of Status Change: | 03 Dec 2019 (5 years ago) |
| Identification Number: | 000147048 |
| ZIP code: | 02904 |
| County: | Providence County |
| Principal Address: | 1630 MINERAL SPRING AVENUE SUITE 2, NORTH PROVIDENCE, RI, 02904, USA |
| Purpose: | PRACTICE OF MEDICINE |
| Fictitious names: |
Health Clinic of RI (trading name, 2011-01-27 - ) |
| Historical names: |
Internal Medicine & Syncope Clinic LLC Health Clinic of R.I., LLC |
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 | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568667848 | 2007-06-18 | 2015-12-16 | 1630 MINERAL SPRING AVE, 2, NORTH PROVIDENCE, RI, 029044043, US | 1630 MINERAL SPRING AVE, 2, NORTH PROVIDENCE, RI, 029044025, US | |||||||||||||||||||
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| Phone | +1 401-438-1010 |
Authorized person
| Name | JAVID CALCATTI |
| Role | DIRECTOR |
| Phone | 4014381010 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CHIP |
| Number | CP408256 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| JAVID CALCATTI | Agent | 1635 MINERAL SPRING AVENUE SUITE 203, NORTH PROVIDENCE, RI, 02904, USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2014-02-24 | Health Clinic of R.I., LLC | WELLNORTH MEDICAL LLC |
| Name Change | 2012-08-24 | Internal Medicine & Syncope Clinic LLC | Health Clinic of R.I., LLC |
| Number | Name | File Date |
|---|---|---|
| 201929129410 | Revocation Certificate For Failure to Maintain a Registered Office | 2019-12-03 |
| 201918887440 | Revocation Notice For Failure to Maintain a Registered Office | 2019-09-11 |
| 201916166420 | Registered Office Not Maintained | 2019-08-26 |
| 201993627650 | Annual Report | 2019-05-20 |
| 201992580280 | Revocation Notice For Failure to File An Annual Report | 2019-05-13 |
| 201863150680 | Annual Report | 2018-04-30 |
| 201627997780 | Annual Report | 2016-11-28 |
| 201589382910 | Annual Report | 2015-12-17 |
| 201589383070 | Annual Report | 2015-12-17 |
| 201589382730 | Reinstatement | 2015-12-17 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 8235167106 | 2020-04-15 | 0165 | PPP | 1630 Mineral Suite 2, North Providence, RI, 02904 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
