| Name: | COASTAL DERM & COSMETIC CENTER, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 25 Jul 2013 (11 years ago) |
| Identification Number: | 000814970 |
| ZIP code: | 02910 |
| County: | Providence County |
| Principal Address: | 750 RESERVOIR AVE., CRANSTON, RI, 02910, USA |
| Purpose: | DERMATOLOGY PATIENT CLINICAL SERVICES AND SKIN CARE. Title: 7-1.2-1701 |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| Fictitious names: |
COASTAL DERMATOLOGY & COSMETIC CENTER (trading name, 2015-04-15 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528487683 | 2014-04-15 | 2024-09-09 | 1539 ATWOOD AVE, SUITE 301, JOHNSTON, RI, 029193262, US | 1539 ATWOOD AVE, SUITE 301, JOHNSTON, RI, 029193262, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 401-490-4515 |
| Fax | 4014904516 |
Authorized person
| Name | HUA ZHOU |
| Role | OWNER |
| Phone | 4014904515 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CHUNSONG LUO | Agent | 1539 ATWOOD AVENUE SUITE 301, JOHNSTON, RI, 02919, USA |
| Name | Role | Address |
|---|---|---|
| HAU ZHOU | PRESIDENT | 19 BELLE ISLE WAY CRANSTON, RI 02921 USA |
| Name | Role | Address |
|---|---|---|
| SU LUO | VICE PRESIDENT | 26 MISS FRY DRIVE EAST GREENWICH, RI 02818 USA |
| Name | Role | Address |
|---|---|---|
| CHUNSONG LUO | OTHER OFFICER | 19 BELLE ISLE WAY CRANSTON, RI 02921 USA |
| Number | Name | File Date |
|---|---|---|
| 202444692780 | Annual Report | 2024-01-25 |
| 202340539710 | Annual Report - Amended | 2023-08-24 |
| 202328065820 | Annual Report | 2023-02-09 |
| 202328065730 | Annual Report - Amended | 2023-02-09 |
| 202208467630 | Annual Report | 2022-01-23 |
| 202184806070 | Annual Report | 2021-01-06 |
| 202032561670 | Annual Report | 2020-01-17 |
| 201883034010 | Annual Report | 2018-12-21 |
| 201755087960 | Annual Report | 2017-12-15 |
| 201629258690 | Annual Report | 2016-12-30 |
Date of last update: 17 Oct 2024
Sources: Rhode Island Department of State
