| Name: | DIALYSIS CENTER OF WESTERLY LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 22 Jun 2005 (20 years ago) |
| Identification Number: | 000148897 |
| Place of Formation: | DELAWARE |
| Principal Address: | 500 CUMMINGS CENTER SUITE 6550, BEVERLY, MA, 01915, USA |
| Mailing Address: | 1 RHODY DRIVE, WESTERLY, MA, 01915, 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 | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588609234 | 2006-06-17 | 2023-01-10 | 1 RHODY DR, WESTERLY, RI, 028912920, US | 1 RHODY DR, WESTERLY, RI, 028912920, US | |||||||||||||||||||||
|
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| Phone | +1 401-596-0368 |
| Fax | 4015969614 |
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 | DC61456 |
| 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 | 290 BLACKSTONE BLVD PROVIDENCE, RI 02906 USA |
| Number | Name | File Date |
|---|---|---|
| 202451801650 | Annual Report | 2024-04-22 |
| 202334129370 | Annual Report | 2023-04-26 |
| 202217500740 | Statement of Change of Registered/Resident Agent | 2022-05-19 |
| 202214712470 | Annual Report | 2022-04-14 |
| 202103219280 | Annual Report | 2021-10-14 |
| 202065046760 | Annual Report | 2020-10-15 |
| 201924370600 | Annual Report | 2019-10-16 |
| 201877736030 | Annual Report | 2018-09-18 |
| 201749849440 | Annual Report | 2017-09-18 |
| 201609487050 | Annual Report | 2016-09-27 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
