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  5. William T. Chen Medical, Inc.

William T. Chen Medical, Inc.

Company Details

Name: William T. Chen Medical, Inc.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Dissolved
Date of Organization in Rhode Island: 19 Jun 2012 (13 years ago)
Date of Dissolution: 31 Dec 2020 (4 years ago)
Date of Status Change: 31 Dec 2020 (4 years ago)
Identification Number: 000791187
ZIP code: 02905
County: Providence County
Principal Address: 33 STANIFORD STREET, PROVIDENCE, RI, 02905, USA
Purpose: ENGAGE IN THE PRACTICE OF MEDICINE
NAICS: 621111 - Offices of Physicians (except Mental Health Specialists)

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WILLIAM T. CHEN MEDICAL, INC. RETIREMENT PLAN 2012 264059934 2013-06-20 WILLIAM T. CHEN MEDICAL, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 4014218800
Plan sponsor’s address 33 STANIFORD STREET, PROVIDENCE, RI, 02905

Plan administrator’s name and address
Administrator’s EIN 264059934
Plan administrator’s name WILLIAM T. CHEN MEDICAL, INC.
Plan administrator’s address 33 STANIFORD STREET, PROVIDENCE, RI, 02905
Administrator’s telephone number 4014218800

Signature of
Role Plan administrator
Date 2013-06-20
Name of individual signing JAMES W. STAUFFER
Valid signature Filed with authorized/valid electronic signature
WILLIAM T. CHEN MEDICAL, INC. RETIREMENT PLAN 2011 264059934 2012-07-17 WILLIAM T. CHEN MEDICAL, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 4014218800
Plan sponsor’s address 33 STANIFORD STREET, PROVIDENCE, RI, 02905

Plan administrator’s name and address
Administrator’s EIN 264059934
Plan administrator’s name WILLIAM T. CHEN MEDICAL, INC.
Plan administrator’s address 33 STANIFORD STREET, PROVIDENCE, RI, 02905
Administrator’s telephone number 4014218800

Signature of
Role Plan administrator
Date 2012-07-17
Name of individual signing JAMES W. STAUFFER
Valid signature Filed with authorized/valid electronic signature
WILLIAM T. CHEN MEDICAL, INC. RETIREMENT PLAN 2010 264059934 2011-06-29 WILLIAM T. CHEN MEDICAL, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 4014218800
Plan sponsor’s address 33 STANIFORD STREET, PROVIDENCE, RI, 02905

Plan administrator’s name and address
Administrator’s EIN 264059934
Plan administrator’s name WILLIAM T. CHEN MEDICAL, INC.
Plan administrator’s address 33 STANIFORD STREET, PROVIDENCE, RI, 02905
Administrator’s telephone number 4014218800

Signature of
Role Plan administrator
Date 2011-06-29
Name of individual signing WILLIAM T. CHEN, M.D.
Valid signature Filed with authorized/valid electronic signature
WILLIAM T. CHEN MEDICAL, INC. RETIREMENT PLAN 2009 264059934 2010-10-14 WILLIAM T. CHEN MEDICAL, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 4014218800
Plan sponsor’s address 33 STANIFORD STREET, PROVIDENCE, RI, 02905

Plan administrator’s name and address
Administrator’s EIN 264059934
Plan administrator’s name WILLIAM T. CHEN MEDICAL, INC.
Plan administrator’s address 33 STANIFORD STREET, PROVIDENCE, RI, 02905
Administrator’s telephone number 4014218800

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing CAROL LIPMAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
STEPHEN D. ZUBIAGO, ESQ. Agent NIXON PEABODY LLP ONE CITIZENS PLAZA SUITE 500, PROVIDENCE, RI, 02903, USA

PRESIDENT

Name Role Address
WILLIAM T CHEN MD PRESIDENT 33 STANIFORD STREET PROVIDENCE, RI 02905 USA

Filings

Number Name File Date
202083137040 Articles of Dissolution 2020-12-31
202033707590 Annual Report 2020-02-03
201985017470 Annual Report 2019-01-22
201857220300 Annual Report 2018-01-29
201732302620 Annual Report 2017-02-03
201691197220 Annual Report 2016-01-25
201554113400 Annual Report 2015-01-23
201433120550 Annual Report 2014-01-16
201313425850 Annual Report 2013-03-01
201294119890 Articles of Incorporation 2012-06-19

Related by officers

STEPHEN D. ZUBIAGO, ESQ.

Nicholas A. Califano, M.D., Inc. CARDIOLOGY ASSOCIATES, INC. MIRIAM IPA, INC. ORTHOPEDIC GROUP, INC. Bayside Endoscopy Group, Inc. Mobile Storage Inc. H & H TRUCKING INC. MIRIAM PHO, INC. Bayside OB-GYN, Inc. West Bay Orthopaedics and Neurosurgery, Inc.

Related by address

33 STANIFORD STREET, PROVIDENCE, RI, 02905, USA

Nicholas A. Califano, M.D., Inc. SHELDON LIDOFSKY, M.D. INC. Bayside Endoscopy Group, Inc. Thomas D. DeNucci, M.D., Inc. Paul E.A. VanZuiden, M,D., F.A.C.P., Inc. University Gastroenterology Practice, Inc. Paul A. Akerman, M.D., Inc. Thomas E. Sepe, M.D., Inc. Peter S. Margolis, M.D., Inc. STANIFORD REALTY, LLC

Date of last update: 17 Oct 2024

Sources: Rhode Island Department of State

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