| Name: | Dr. Ghazi Accaoui, M.D., Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 13 Aug 2010 (14 years ago) |
| Date of Dissolution: | 08 Dec 2022 (2 years ago) |
| Date of Status Change: | 08 Dec 2022 (2 years ago) |
| Identification Number: | 000548151 |
| ZIP code: | 02863 |
| County: | Providence County |
| Principal Address: | 521 ROOSEVELT AVENUE, CENTRAL FALLS, RI, 02863, USA |
| Purpose: | MEDICAL PRACTICE |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104134154 | 2010-09-23 | 2010-09-23 | 124 BROAD STREET., PAWTUCKET, RI, 028602052, US | 124 BROAD STREET., PAWTUCKET, RI, 028602052, US | |||||||||||||||||||||||||||
|
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| Phone | +1 401-729-6000 |
| Fax | 4013122929 |
Authorized person
| Name | DR. GHAZI ACCAOUI |
| Role | PRESIDENT |
| Phone | 4017296000 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | 03860 |
| State | RI |
| Is Primary | Yes |
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | 6489 |
| State | RI |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| TIN LAI WONG | Agent | 521 ROOSEVELT AVE, CENTRAL FALLS, RI, 02863, USA |
| Name | Role | Address |
|---|---|---|
| TIN LAI WONG | PRESIDENT | 521 ROOSEVELT AVENUE CENTRAL FALLS, RI 02863 USA |
| Number | Name | File Date |
|---|---|---|
| 202225105250 | Articles of Dissolution | 2022-12-08 |
| 202212441750 | Annual Report | 2022-03-02 |
| 202187943880 | Annual Report | 2021-01-25 |
| 202185855590 | Statement of Change of Registered Office by the Registered Agent | 2021-01-11 |
| 202033258010 | Annual Report | 2020-01-27 |
| 201988151180 | Annual Report | 2019-03-04 |
| 201856388470 | Annual Report | 2018-01-18 |
| 201734502460 | Annual Report | 2017-02-21 |
| 201692503570 | Statement of Change of Registered/Resident Agent | 2016-02-16 |
| 201691307160 | Revocation Notice For Failure to Maintain a Registered Office | 2016-01-27 |
Date of last update: 14 Oct 2024
Sources: Rhode Island Department of State
