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  5. TRI COUNTY UROLOGY, LLC

TRI COUNTY UROLOGY, LLC

Company Details

Name: TRI COUNTY UROLOGY, LLC
Jurisdiction: Rhode Island
Entity type: Domestic Limited Liability Company
Status: Revoked Entity
Date of Organization in Rhode Island: 05 Dec 2007 (17 years ago)
Date of Dissolution: 03 Jun 2021 (4 years ago)
Date of Status Change: 03 Jun 2021 (4 years ago)
Identification Number: 000276153
ZIP code: 02886
County: Kent County
Principal Address: 176 TOLLGATE ROAD SUITE 301, WARWICK, RI, 02886, USA
Purpose: MEDICAL DOCTORS OFFICE
NAICS: 621111 - Offices of Physicians (except Mental Health Specialists)

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TRI COUNTY UROLOGY ROTH SAFE-HARBOR 401(K) PROFIT SHARING PLAN 2017 050514531 2018-06-14 TRI COUNTY UROLOGY, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-07-01
Business code 621111
Sponsor’s telephone number 4017392984
Plan sponsor’s address 176 TOLL GATE ROAD, SUITE 301, WARWICK, RI, 028864481
TRI COUNTY UROLOGY ROTH SAFE-HARBOR 401(K) PROFIT SHARING PLAN 2016 050514531 2017-06-02 TRI COUNTY UROLOGY, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-07-01
Business code 621111
Sponsor’s telephone number 4017392984
Plan sponsor’s address 176 TOLL GATE ROAD, SUITE 301, WARWICK, RI, 028864481
TRI COUNTY UROLOGY ROTH SAFE-HARBOR 401(K) PROFIT SHARING PLAN 2015 050514531 2016-10-13 TRI COUNTY UROLOGY LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-07-01
Business code 621111
Sponsor’s telephone number 4017392984
Plan sponsor’s address 176 TOLLGATE ROAD, SUITE 301, WARWICK, RI, 02886

Signature of
Role Plan administrator
Date 2016-10-13
Name of individual signing KIM ZIZZA
Valid signature Filed with authorized/valid electronic signature
TRI COUNTY UROLOGY ROTH SAFE-HARBOR 401(K) PROFIT SHARING PLAN 2014 050514531 2015-07-30 TRI COUNTY UROLOGY LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-07-01
Business code 621111
Sponsor’s telephone number 4017392984
Plan sponsor’s address 176 TOLLGATE ROAD, SUITE 301, WARWICK, RI, 02886

Signature of
Role Plan administrator
Date 2015-07-30
Name of individual signing KIM ZIZZA
Valid signature Filed with authorized/valid electronic signature
TRI COUNTY UROLOGY ROTH SAFE-HARBOR 401(K) PROFIT SHARING PLAN 2013 050514531 2014-05-30 TRI COUNTY UROLOGY LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-07-01
Business code 621111
Sponsor’s telephone number 4017392984
Plan sponsor’s address 176 TOLLGATE ROAD, SUITE 301, WARWICK, RI, 02886

Signature of
Role Plan administrator
Date 2014-05-30
Name of individual signing KIM ZIZZA
Valid signature Filed with authorized/valid electronic signature
TRI COUNTY UROLOGY ROTH SAFE-HARBOR 401(K) PROFIT SHARING PLAN 2012 050514531 2013-07-15 TRI COUNTY UROLOGY LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-07-01
Business code 621111
Sponsor’s telephone number 4017392984
Plan sponsor’s address 176 TOLLGATE ROAD, SUITE 301, WARWICK, RI, 02886

Signature of
Role Plan administrator
Date 2013-07-15
Name of individual signing KIM ZIZZA
Valid signature Filed with authorized/valid electronic signature
TRI COUNTY UROLOGY ROTH SAFE-HARBOR 401(K) PROFIT SHARING PLAN 2011 050514531 2012-07-18 TRI COUNTY UROLOGY LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-07-01
Business code 621111
Sponsor’s telephone number 4017392984
Plan sponsor’s address 176 TOLLGATE ROAD, SUITE 301, WARWICK, RI, 02886

Plan administrator’s name and address
Administrator’s EIN 050514531
Plan administrator’s name TRI COUNTY UROLOGY LLC
Plan administrator’s address 176 TOLLGATE ROAD, SUITE 301, WARWICK, RI, 02886
Administrator’s telephone number 4017392984

Signature of
Role Plan administrator
Date 2012-07-18
Name of individual signing KIM ZIZZA
Valid signature Filed with authorized/valid electronic signature
TRI COUNTY UROLOGY ROTH SAFE-HARBOR 401(K) PROFIT SHARING PLAN 2010 050514531 2011-06-22 TRI COUNTY UROLOGY LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-07-01
Business code 621111
Sponsor’s telephone number 4017392984
Plan sponsor’s address 176 TOLLGATE ROAD, SUITE 301, WARWICK, RI, 02886

Plan administrator’s name and address
Administrator’s EIN 050514531
Plan administrator’s name TRI COUNTY UROLOGY LLC
Plan administrator’s address 176 TOLLGATE ROAD, SUITE 301, WARWICK, RI, 02886
Administrator’s telephone number 4017392984

Signature of
Role Plan administrator
Date 2011-06-22
Name of individual signing KIM ZIZZA
Valid signature Filed with authorized/valid electronic signature
TRI COUNTY UROLOGY ROTH SAFE-HARBOR 401(K) PROFIT SHARING PLAN 2009 050514531 2010-08-18 TRI COUNTY UROLOGY LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-07-01
Business code 621111
Sponsor’s telephone number 4017392984
Plan sponsor’s address 176 TOLLGATE ROAD, SUITE 301, WARWICK, RI, 02886

Plan administrator’s name and address
Administrator’s EIN 050514531
Plan administrator’s name TRI COUNTY UROLOGY LLC
Plan administrator’s address 176 TOLLGATE ROAD, SUITE 301, WARWICK, RI, 02886
Administrator’s telephone number 4017392984

Signature of
Role Plan administrator
Date 2010-08-18
Name of individual signing PATRICIA MCGOWAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MARC A. GREENFIELD, ESQ. Agent 116 ORANGE STREET, PROVIDENCE, RI, 02903, USA

Filings

Number Name File Date
202197408250 Revocation Certificate For Failure to File the Annual Report for the Year 2021-06-03
202194401100 Revocation Notice For Failure to File An Annual Report 2021-03-16
201923564640 Annual Report 2019-10-07
201881623180 Annual Report 2018-11-23
201751005030 Annual Report 2017-10-04
201748260200 Statement of Change of Registered/Resident Agent Office 2017-08-07
201610530220 Annual Report 2016-10-17
201581165160 Annual Report 2015-09-30
201447403070 Annual Report 2014-10-09
201327844140 Annual Report 2013-09-06

Related by officers

MARC A. GREENFIELD, ESQ.

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Related by address

No related companies by address

Date of last update: 11 Oct 2024

Sources: Rhode Island Department of State

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