| Name: | Physician Assist LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 17 Apr 2009 (16 years ago) |
| Date of Dissolution: | 01 Jun 2015 (10 years ago) |
| Date of Status Change: | 01 Jun 2015 (10 years ago) |
| Identification Number: | 000506109 |
| ZIP code: | 02879 |
| County: | Washington County |
| Principal Address: | 490 MIDDLEBRIDGE ROAD, WAKEFIELD, RI, 02879, USA |
| Purpose: | Assist physicians in all aspects of patient care. |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669702569 | 2009-12-28 | 2009-12-28 | 35 BROAD ROCK RD, WAKEFIELD, RI, 028791872, US | 35 BROAD ROCK RD, WAKEFIELD, RI, 028791872, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 401-265-4553 |
Authorized person
| Name | MR. MICHAEL JOHN COBB |
| Role | OWNER |
| Phone | 4012654553 |
Taxonomy
| Taxonomy Code | 363AS0400X - Surgical Physician Assistant |
| License Number | PA00255 |
| State | RI |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MICHAEL COBB | Agent | 490 MIDDLEBRIDGE ROAD, WAKEFIELD, RI, 02879, USA |
| Number | Name | File Date |
|---|---|---|
| 201562135960 | Revocation Certificate For Failure to File the Annual Report for the Year | 2015-06-01 |
| 201556445950 | Revocation Notice For Failure to File An Annual Report | 2015-03-04 |
| 201434582320 | Annual Report | 2014-01-30 |
| 201433425150 | Revocation Notice For Failure to File An Annual Report | 2014-01-17 |
| 201296734000 | Annual Report | 2012-09-05 |
| 201296733940 | Statement of Change of Registered/Resident Agent Office | 2012-09-05 |
| 201296494850 | Revocation Notice For Failure to Maintain a Registered Office | 2012-08-29 |
| 201296451970 | Registered Office Not Maintained | 2012-08-14 |
| 201183903520 | Annual Report | 2011-10-06 |
| 201066781690 | Annual Report | 2010-08-31 |
Date of last update: 14 Oct 2024
Sources: Rhode Island Department of State
