Search icon

CCR PHARMACY, LLC

Company Details

Name: CCR PHARMACY, LLC
Jurisdiction: Rhode Island
Entity type: Domestic Limited Liability Company
Status: Activ
Date of Organization in Rhode Island: 06 Sep 2007 (18 years ago)
Identification Number: 000221299
ZIP code: 02886
County: Kent County
Principal Address: 1165 MAIN AVENUE, WARWICK, RI, 02886, USA
Mailing Address: 50 PARK ROW WEST SUITE 107, PROVIDENCE, RI, 02903, USA
Purpose: TO ACT AS A PHARMACY
Fictitious names: J.B. Pharmacy II, LLC (trading name, 2007-09-06 - )

Industry & Business Activity

NAICS

446110 Pharmacies and Drug Stores

This industry comprises establishments known as pharmacies and drug stores engaged in retailing prescription or nonprescription drugs and medicines. Learn more at the U.S. Census Bureau

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1609306919 2017-06-19 2021-03-24 1017 SMITH ST, PROVIDENCE, RI, 02908, US 1017 SMITH ST, PROVIDENCE, RI, 029082747, US

Contacts

Phone +1 401-861-1194
Fax 4013837773

Authorized person

Name PAUL CAPUANO
Role PHARMACIST/OWNER
Phone 4018611194

Taxonomy

Taxonomy Code 333600000X - Pharmacy
Is Primary No
Taxonomy Code 3336C0004X - Compounding Pharmacy
Is Primary No
Taxonomy Code 3336L0003X - Long Term Care Pharmacy
License Number PHA00542
State RI
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number JP68164
State RI
Issuer PK
Number 2169883

Agent

Name Role Address
STEPHEN J. DIGIANFILIPPO, ESQ. Agent VIEIRA & DIGIANFILIPPO LTD. 50 PARK ROW WEST, PROVIDENCE, RI, 02903, USA

Filings

Number Name File Date
202452113310 Annual Report 2024-04-22
202452113040 Statement of Change of Registered/Resident Agent Office 2024-04-22
202329390660 Annual Report 2023-02-24
202213642570 Annual Report 2022-03-24
202103832470 Annual Report 2021-10-22
202065351990 Annual Report 2020-10-13
201930459630 Annual Report - Amended 2019-12-19
201926681100 Annual Report 2019-10-30
201879743900 Annual Report 2018-10-18
201751441630 Annual Report 2017-10-11

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
6960857203 2020-04-28 0165 PPP 1165 Main Ave, Warwick, RI, 02886
Loan Status Date 2021-08-12
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 102300
Loan Approval Amount (current) 102300
Undisbursed Amount 0
Franchise Name -
Lender Location ID 455644
Servicing Lender Name Live Oak Banking Company
Servicing Lender Address 1741 Tiburon Dr, WILMINGTON, NC, 28403-6244
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Warwick, KENT, RI, 02886-0004
Project Congressional District RI-02
Number of Employees 15
NAICS code 446110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 455644
Originating Lender Name Live Oak Banking Company
Originating Lender Address WILMINGTON, NC
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 103555.63
Forgiveness Paid Date 2021-07-26
3105618410 2021-02-04 0165 PPS 1165 Main Ave, Warwick, RI, 02886-1940
Loan Status Date 2022-01-11
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 115856
Loan Approval Amount (current) 115856
Undisbursed Amount 0
Franchise Name -
Lender Location ID 455644
Servicing Lender Name Live Oak Banking Company
Servicing Lender Address 1741 Tiburon Dr, WILMINGTON, NC, 28403-6244
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Warwick, KENT, RI, 02886-1940
Project Congressional District RI-02
Number of Employees 14
NAICS code 446110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 455644
Originating Lender Name Live Oak Banking Company
Originating Lender Address WILMINGTON, NC
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 116763.8
Forgiveness Paid Date 2021-12-09

Date of last update: 10 Oct 2024

Sources: Rhode Island Department of State