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Rhode Island Dermatology OBS, LLC

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Company Details

Name: Rhode Island Dermatology OBS, LLC
Jurisdiction: Rhode Island
Entity type: Domestic Limited Liability Company
Status: Revoked Entity
Date of Organization in Rhode Island: 12 Mar 2007 (18 years ago)
Date of Dissolution: 01 Jun 2015 (10 years ago)
Date of Status Change: 01 Jun 2015 (10 years ago)
Identification Number: 000162471
ZIP code: 02865
City: Lincoln
County: Providence County
Purpose: TO OPERATE A PHYSICIAN AMBULATORY SURGERY CENTER
Principal Address: Google Maps Logo 3 WAKE ROBIN ROAD, LINCOLN, RI, 02865, USA

Agent

Name Role Address
JAMES P. REDDING, ESQ. Agent 27 SAKONNET POINT ROAD, LITTLE COMPTON, RI, 02837, USA

National Provider Identifier

NPI Number:
1235202201

Authorized Person:

Name:
MS. SUSAN SCHUMACHER
Role:
BILLING MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
4014759143

Licenses

License No License Type Status Date Issued Expiration Date
PHS00011 Physician Ambulatory Surgery Center Expired 2007-09-17 2013-12-31

Filings

Number Name File Date
201562108270 Revocation Certificate For Failure to File the Annual Report for the Year 2015-06-01
201556539550 Revocation Notice For Failure to File An Annual Report 2015-03-04
201438027340 Statement of Change of Registered/Resident Agent 2014-04-04
201330291650 Annual Report 2013-11-01
201204920510 Annual Report 2012-12-13

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Date of last update: 12 Jul 2025

Sources: Rhode Island Department of State