| Name: | Sampalis EyeCare P.C. |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 11 Dec 2012 (12 years ago) |
| Identification Number: | 000794989 |
| ZIP code: | 02910 |
| County: | Providence County |
| Principal Address: | 1013 RESERVOIR AVENUE, CRANSTON, RI, 02910, USA |
| Purpose: | EYE CARE SERVICES |
| NAICS: | 339112 - Surgical and Medical Instrument Manufacturing |
| Fictitious names: |
Dry Eye Center of RI (trading name, 2022-10-18 - ) MS Vision (trading name, 2022-10-18 - ) Cranston Eye Associates, Inc. (trading name, 2020-09-03 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497016661 | 2012-06-05 | 2013-05-02 | 24 SCARALIA RD, CRANSTON, RI, 02921, US | 650 BALD HILL RD, WARWICK, RI, 028861863, US | |||||||||||||||||||||||||||||||||||
|
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| Phone | +1 401-241-9188 |
| Fax | 4018284240 |
| Phone | +1 401-822-2050 |
| Fax | 4018222050 |
Authorized person
| Name | DR. MARIA P SAMPALIS |
| Role | DR |
| Phone | 4012419188 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | MA4629 |
| State | MA |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 110079003A |
| State | MA |
| Issuer | MEDICAID |
| Number | MS90656 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| JAY N. ROSENSTEIN | Agent | 30 CHAPEL VIEW BLVD. SUITE 220, CRANSTON, RI, 02920, USA |
| Name | Role | Address |
|---|---|---|
| MARIA SAMPALIS | PRESIDENT | 1013 RESERVOIR AVENUE CRANSTON, RI 02910 USA |
| Number | Name | File Date |
|---|---|---|
| 202452950320 | Annual Report | 2024-04-29 |
| 202328683880 | Annual Report | 2023-02-14 |
| 202224170510 | Fictitious Business Name Statement | 2022-10-18 |
| 202224170240 | Fictitious Business Name Statement | 2022-10-18 |
| 202213160010 | Annual Report | 2022-03-16 |
| 202189073170 | Annual Report | 2021-01-28 |
| 202067806100 | Statement of Change of Registered Office by the Registered Agent | 2020-10-23 |
| 202051873570 | Fictitious Business Name Statement | 2020-09-03 |
| 202033143820 | Annual Report | 2020-01-21 |
| 201984454140 | Annual Report | 2019-01-14 |
Date of last update: 17 Oct 2024
Sources: Rhode Island Department of State
