| Name: | Primary Care Partners, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 07 Feb 2011 (14 years ago) |
| Date of Dissolution: | 25 Feb 2013 (12 years ago) |
| Date of Status Change: | 25 Feb 2013 (12 years ago) |
| Identification Number: | 000577495 |
| ZIP code: | 02886 |
| County: | Kent County |
| Principal Address: | 2756 POST ROAD SUITE 104, WARWICK, RI, 02886, USA |
| Purpose: | PROVIDING PERSONS WITH INTEGRATED PRIMARY CARE, BEHAVIORAL HEALTH AND WELLNESS SERVICES DESIGNED TO MEET THEIR NEEDS |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548538473 | 2011-12-07 | 2012-11-02 | 2756 POST RD, WARWICK, RI, 028863003, US | 2756 POST RD, WARWICK, RI, 028863003, US | |||||||||||||||||||||||
|
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| Phone | +1 401-691-6000 |
| Fax | 4017387718 |
Authorized person
| Name | DAVID LAUTERBACH |
| Role | PRESIDENT/CEO |
| Phone | 4016916000 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | TH87001 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| DAVID S. LAUTERBACH | Agent | 2756 POST ROAD SUITE 104, WARWICK, RI, 02886, USA |
| Name | Role | Address |
|---|---|---|
| MARK DELANEY | PRESIDENT | 9 WHISPER LANE NORTH KINGSTOWN, RI 02852 USA |
| Name | Role | Address |
|---|---|---|
| DAVID S. LAUTERBACH | DIRECTOR | 180 JUNIPER DRIVE NORTH KINGSTOWN, RI 02852 USA |
| Number | Name | File Date |
|---|---|---|
| 201312627390 | Articles of Dissolution | 2013-02-25 |
| 201294496450 | Annual Report | 2012-07-02 |
| 201174516830 | Articles of Incorporation | 2011-02-07 |
Date of last update: 15 Oct 2024
Sources: Rhode Island Department of State
