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  5. Pedro Barros, M.D., Inc.

Pedro Barros, M.D., Inc.

Company Details

Name: Pedro Barros, M.D., Inc.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Dissolved
Date of Organization in Rhode Island: 31 Mar 2009 (16 years ago)
Date of Dissolution: 28 Feb 2012 (13 years ago)
Date of Status Change: 28 Feb 2012 (13 years ago)
Identification Number: 000505752
ZIP code: 02905
County: Providence County
Principal Address: 33 STANFORD STREET, PROVIDENCE, RI, 02905, USA
Purpose: MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1790928422 2009-04-10 2009-04-10 33 STANIFORD ST, PROVIDENCE, RI, 029053105, US 1407 S COUNTY TRL, BUILDING 4 SUITE 410, EAST GREENWICH, RI, 028181652, US

Contacts
Phone +1 401-421-8800
Fax 4012736510
Phone +1 401-886-4040
Fax 4018864010

Authorized person
Name PEDRO M BARROS
Role PHYSICIAN/OWNER
Phone 4018864040

Taxonomy
Taxonomy Code 207RG0100X - Gastroenterology Physician
License Number 11144
State RI
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PEDRO BARROS, M.D., INC. RETIREMENT PLAN 2012 264562421 2013-06-20 PEDRO BARROS, M.D., INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 4014218800
Plan sponsor’s address 33 STANIFORD STREET 2ND FLOOR, PROVIDENCE, RI, 02905

Plan administrator’s name and address
Administrator’s EIN 264562421
Plan administrator’s name PEDRO BARROS, M.D., INC.
Plan administrator’s address 33 STANIFORD STREET 2ND FLOOR, PROVIDENCE, RI, 02905
Administrator’s telephone number 4014218800

Signature of
Role Plan administrator
Date 2013-06-20
Name of individual signing JAMES W. STAUFFER
Valid signature Filed with authorized/valid electronic signature
PEDRO BARROS, M.D., INC. RETIREMENT PLAN 2011 264562421 2012-07-09 PEDRO BARROS, M.D., INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 4014218800
Plan sponsor’s address 33 STANIFORD STREET 2ND FLOOR, PROVIDENCE, RI, 02905

Plan administrator’s name and address
Administrator’s EIN 264562421
Plan administrator’s name PEDRO BARROS, M.D., INC.
Plan administrator’s address 33 STANIFORD STREET 2ND FLOOR, PROVIDENCE, RI, 02905
Administrator’s telephone number 4014218800

Signature of
Role Plan administrator
Date 2012-07-09
Name of individual signing PEDRO BARROS, M.D.
Valid signature Filed with authorized/valid electronic signature
PEDRO BARROS, M.D., INC. RETIREMENT PLAN 2010 264562421 2011-07-01 PEDRO BARROS, M.D., INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 4014218800
Plan sponsor’s address 33 STANIFORD STREET 2ND FLOOR, PROVIDENCE, RI, 02905

Plan administrator’s name and address
Administrator’s EIN 264562421
Plan administrator’s name PEDRO BARROS, M.D., INC.
Plan administrator’s address 33 STANIFORD STREET 2ND FLOOR, PROVIDENCE, RI, 02905
Administrator’s telephone number 4014218800

Signature of
Role Plan administrator
Date 2011-07-01
Name of individual signing PEDRO BARROS, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
STEPHEN D. ZUBIAGO Agent NIXON PEABODY LLP ONE CITIZENS PLAZA SUITE 500, PROVIDENCE, RI, 02903, USA

PRESIDENT

Name Role Address
PEDRO BARROS, M.D. PRESIDENT 33 STANFORD STREET PROVIDENCE, RI 02905 USA

Filings

Number Name File Date
201290323660 Articles of Dissolution 2012-02-28
201174252170 Annual Report 2011-01-31
201059427840 Annual Report 2010-02-23
200944729900 Articles of Incorporation 2009-03-31

Related by officers

STEPHEN D. ZUBIAGO

ROGER WILLIAMS UNIVERSITY Renaissance Medical, Ltd. South County Health Care Associates, Inc. Howard S. Lilienfeld, M.D., P.C. Roger Williams Medical Associates, Inc. Southern New England Occupational Health, L.L.C. Transcription Associates of Southeastern New England, Inc. American Home Care Services, Inc. Access Bahavioral Care, Inc. Hoop Specialists, LLC

Related by address

33 STANFORD STREET, PROVIDENCE, RI, 02905, USA

William T. Chen Medical, Inc.

Date of last update: 14 Oct 2024

Sources: Rhode Island Department of State

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