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WICKFORD FAMILY MEDICINE LLC

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Company Details

Name: WICKFORD FAMILY MEDICINE LLC
Jurisdiction: Rhode Island
Entity type: Domestic Limited Liability Company
Status: Dissolved
Date of Organization in Rhode Island: 01 Mar 2011 (14 years ago)
Date of Dissolution: 22 Dec 2023 (2 years ago)
Date of Status Change: 22 Dec 2023 (2 years ago)
Identification Number: 000591669
ZIP code: 02852
City: North Kingstown
County: Washington County
Purpose: SOLO FAMILY PRACTICE PROVIDING MEDICAL CARE.
Principal Address: Google Maps Logo 320 PHILLIPS STREET SUITE 102, NORTH KINGSTOWN, RI, 02852, USA

Industry & Business Activity

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

Agent

Name Role Address
JOHN JOSEPH MACHATA Agent 103 WEST MAIN STREET, NORTH KINGSTOWN, RI, 02852, USA

National Provider Identifier

NPI Number:
1104124734

Authorized Person:

Name:
JOHN MACHATA
Role:
MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Filings

Number Name File Date
202343551160 Articles of Dissolution 2023-12-22
202328266100 Annual Report 2023-02-13
202217719520 Annual Report 2022-05-20
202100610260 Annual Report 2021-09-01
202056040580 Annual Report 2020-09-21

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Date of last update: 13 Jul 2025

Sources: Rhode Island Department of State