| Name: | PROVIDENCE INTERVENTIONAL ASSOCIATES II, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 18 Oct 2011 (13 years ago) |
| Identification Number: | 000720234 |
| Principal Address: | 920 WINTER STREET, WALTHAM, MA, 02451, USA |
| Mailing Address: | 52 E SWEDESFORD ROAD, MALVERN, PA, 19355, USA |
| Purpose: | VASCULAR ACCESS SERVICES |
| NAICS: | 621512 - Diagnostic Imaging Centers |
| Fictitious names: |
Providence Access Physicians (trading name, 2019-07-09 - ) Providence Access Care (trading name, 2018-11-01 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497220412 | 2018-10-05 | 2023-05-09 | 100 HIGHLAND AVE STE 100, PROVIDENCE, RI, 029062740, US | 100 HIGHLAND AVE STE 100, PROVIDENCE, RI, 029062740, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 401-277-9729 |
| Fax | 4012779730 |
Authorized person
| Name | DR. JONAH LICHT |
| Role | OWNER |
| Phone | 4012779729 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JONAH LICHT | Agent | 100 HIGHLAND AVENUE SUITE 100, PROVIDENCE, RI, 02906, USA |
| Number | Name | File Date |
|---|---|---|
| 202450205170 | Annual Report | 2024-04-05 |
| 202327990060 | Annual Report | 2023-02-09 |
| 202215130930 | Annual Report | 2022-04-19 |
| 202103091930 | Annual Report | 2021-10-13 |
| 202061295360 | Annual Report | 2020-10-05 |
| 201925928990 | Annual Report | 2019-10-29 |
| 201902857280 | Fictitious Business Name Statement | 2019-07-09 |
| 201880649190 | Fictitious Business Name Statement | 2018-11-01 |
| 201880554890 | Annual Report | 2018-10-31 |
| 201748967640 | Annual Report | 2017-08-31 |
Date of last update: 16 Oct 2024
Sources: Rhode Island Department of State
