| 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)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
| 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 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6350817205 | 2020-04-28 | 0165 | PPP | 32 MAPLEHURST DR, NARRAGANSETT, RI, 02882 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 8745008503 | 2021-03-10 | 0165 | PPS | 190 Commerce Dr, Warwick, RI, 02886-2430 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 17 Oct 2024
Sources: Rhode Island Department of State
