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JENNIFER SOUTHER MD, INC.

Company Details

Name: JENNIFER SOUTHER MD, INC.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Revoked Entity
Date of Organization in Rhode Island: 17 Jan 2007 (18 years ago)
Date of Dissolution: 12 Dec 2011 (13 years ago)
Date of Status Change: 12 Dec 2011 (13 years ago)
Identification Number: 000161063
ZIP code: 02886
County: Kent County
Purpose: MEDICAL
Principal Address: Google Maps Logo JOS. FAMIGLIETTI C/O 117 METRO CENTER BOULEVARD-2008, WARWICK, RI, 02886, USA

Agent

Name Role Address
JOSEPH M. FAMIGLIETTI Agent 117 METRO CENTER BOULEVARD, WARWICK, RI, 02886, USA

PRESIDENT

Name Role Address
JENNIFER SOUTHER PRESIDENT 30A MARTIN STREET CUMBERLAND , RI 02864 USA

National Provider Identifier

NPI Number:
1346394616

Authorized Person:

Name:
MS. CARYN RUSSO
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
4013120096

Filings

Number Name File Date
201187021130 Revocation Certificate For Failure to File the Annual Report for the Year 2011-12-12
201182542810 Revocation Notice For Failure to File An Annual Report 2011-09-13
201056194600 Annual Report 2010-01-11
200941180470 Statement of Change of Registered Office by the Registered Agent 2009-01-30
200941220400 Annual Report 2009-01-26

Date of last update: 28 May 2025

Sources: Rhode Island Department of State