| 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 (15 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)This U.S. industry comprises establishments of health practitioners having the degree of M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathy) primarily engaged in the independent practice of general or specialized medicine (except psychiatry or psychoanalysis) or surgery. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. Learn more at the U.S. Census Bureau
| 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
