| Name: | Dr. K. Humulock Internal Medicine, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 02 Jan 2013 (12 years ago) |
| Identification Number: | 000795483 |
| ZIP code: | 02882 |
| County: | Washington County |
| Principal Address: | 32 MAPLEHURST DRIVE, NARRAGANSETT, RI, 02882, USA |
| Purpose: | INTERNAL MEDICINE |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265770937 | 2013-01-30 | 2013-01-30 | 32 MAPLEHURST DR, NARRAGANSETT, RI, 028823815, US | 190 COMMERCE DR, WARWICK, RI, 028862430, US | |||||||||||||||||||||
|
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| Phone | +1 401-413-5332 |
| Fax | 4019215973 |
| Phone | +1 401-921-5970 |
Authorized person
| Name | MR. CHRISTOPHER HUMULOCK |
| Role | OFFICE MANAGER |
| Phone | 4019215970 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | DO00521 |
| State | RI |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KIMBERLY HUMULOCK | Agent | 32 MAPLEHURST DRIVE, NARRAGANSETT, RI, 02882, USA |
| Name | Role | Address |
|---|---|---|
| KIMBERLY HUMULOCK DO | PRESIDENT | 32 MAPLEHURST DR NARRAGANSETT, RI 02882 USA |
| Name | Role | Address |
|---|---|---|
| CHRISTOPHER HUMULOCK | VICE PRESIDENT | 32 MAPLEHURST DR NARRAGANSETT, RI 02882 USA |
| Name | Role | Address |
|---|---|---|
| CHRIS HUMULOCK | OTHER OFFICER | 32 MAPLEHURST DRIVE NARRAGANSETT, RI 02882 USA |
| Number | Name | File Date |
|---|---|---|
| 202457687780 | Annual Report | 2024-07-08 |
| 202457202280 | Revocation Notice For Failure to File An Annual Report | 2024-06-25 |
| 202326166420 | Annual Report | 2023-01-18 |
| 202211412850 | Annual Report | 2022-02-23 |
| 202184801480 | Annual Report | 2021-01-06 |
| 202036561450 | Annual Report | 2020-03-19 |
| 201988365910 | Annual Report | 2019-03-10 |
| 201877310320 | Annual Report | 2018-09-12 |
| 201875589070 | Revocation Notice For Failure to File An Annual Report | 2018-08-24 |
| 201751801920 | Annual Report | 2017-10-18 |
Date of last update: 17 Oct 2024
Sources: Rhode Island Department of State
