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PROSPECT CHARTERCARE RWMC, LLC

Company Details

Name: PROSPECT CHARTERCARE RWMC, LLC
Jurisdiction: Rhode Island
Entity type: Domestic Limited Liability Company
Status: Activ
Date of Organization in Rhode Island: 21 Aug 2013 (11 years ago)
Identification Number: 000823562
Principal Address: 3824 HUGHES AVE., CULVER CITY, CA, 90232, USA
Purpose: HEALTH CARE
NAICS: 621610 - Home Health Care Services
Fictitious names: RWMC East Providence Cancer Center (trading name, 2014-07-29 - )
Roger Williams Medical Center (trading name, 2014-06-20 - )
CharterCARE Home Health Services (trading name, 2014-06-20 - 2018-04-30)
Roger Williams Dermatology Group (trading name, 2014-06-09 - )
CharterCARE Sleep Disorders Center (trading name, 2014-05-23 - )
Roger Williams Cardiology Group (trading name, 2014-03-25 - )
Roger Williams Physician Assistants Group (trading name, 2014-03-25 - )
Roger Williams Hematology Oncology Group (trading name, 2014-03-25 - )
Roger Williams Hospitalist Group (trading name, 2014-03-25 - )
Roger Williams Primary Care Physicians Group (trading name, 2014-03-25 - )
Roger Williams Behavioral Health Group (trading name, 2014-03-25 - )
Roger Williams Nutritionist Group (trading name, 2014-03-25 - )
Roger Williams Surgical Oncology Group (trading name, 2014-03-25 - )
Roger Williams Breast Health Center (trading name, 2014-03-25 - )
Roger Williams Pulmonary Group (trading name, 2014-03-25 - )

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1760977136 2018-06-27 2021-01-11 825 CHALKSTONE AVE, PROVIDENCE, RI, 029084728, US 825 CHALKSTONE AVE, PROVIDENCE, RI, 029084728, US

Contacts
Phone +1 401-456-2000
Fax 4014562029

Authorized person
Name ROBERT JON ELDERS
Role SECRETARY
Phone 7147881249

Taxonomy
Taxonomy Code 207RA0401X - Addiction Medicine (Internal Medicine) Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ROGER WILLIAMS MEDICAL CENTER TAX SHELTERED ANNUITY PROGRAM 2023 050258959 2024-04-10 ROGER WILLIAMS MEDICAL CENTER 0
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1985-01-01
Business code 622000
Sponsor’s telephone number 4014562018
Plan sponsor’s address 825 CHALKSTONE AVE, PROVIDENCE, RI, 02908

Signature of
Role Plan administrator
Date 2024-04-10
Name of individual signing STEPHEN DEL SESTO
Valid signature Filed with authorized/valid electronic signature
ROGER WILLIAMS MEDICAL CENTER TAX SHELTERED ANNUITY PROGRAM 2022 050258959 2023-04-19 ROGER WILLIAMS MEDICAL CENTER 0
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1985-01-01
Business code 622000
Sponsor’s telephone number 4014562018
Plan sponsor’s address 825 CHALKSTONE AVE, PROVIDENCE, RI, 02908

Signature of
Role Plan administrator
Date 2023-04-19
Name of individual signing STEPHEN DEL SESTO
Valid signature Filed with authorized/valid electronic signature
ROGER WILLIAMS MEDICAL CENTER TAX SHELTERED ANNUITY PROGRAM 2021 050258959 2022-03-07 ROGER WILLIAMS MEDICAL CENTER 0
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1985-01-01
Business code 622000
Sponsor’s telephone number 4014562018
Plan sponsor’s address 825 CHALKSTONE AVE, PROVIDENCE, RI, 02908

Signature of
Role Plan administrator
Date 2022-03-07
Name of individual signing THOMAS HEMMENDINGER
Valid signature Filed with authorized/valid electronic signature
ROGER WILLIAMS MEDICAL CENTER TAX SHELTERED ANNUITY PROGRAM 2020 050258959 2021-03-22 ROGER WILLIAMS MEDICAL CENTER 0
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1985-01-01
Business code 622000
Sponsor’s telephone number 4014562018
Plan sponsor’s address 825 CHALKSTONE AVE, PROVIDENCE, RI, 02908

Signature of
Role Plan administrator
Date 2021-03-22
Name of individual signing THOMAS HEMMENDINGER
Valid signature Filed with authorized/valid electronic signature
ROGER WILLIAMS MEDICAL CENTER TAX SHELTERED ANNUITY PROGRAM 2019 050258959 2020-10-14 ROGER WILLIAMS MEDICAL CENTER 0
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1985-01-01
Business code 622000
Sponsor’s telephone number 4014562018
Plan sponsor’s address 825 CHALKSTONE AVE, PROVIDENCE, RI, 02908

Signature of
Role Plan administrator
Date 2020-10-14
Name of individual signing THOMAS HEMMENDINGER
Valid signature Filed with authorized/valid electronic signature
ROGER WILLIAMS MEDICAL CENTER DEFINED CONTRIBUTION PLAN 2018 050258959 2019-01-22 ROGER WILLIAMS MEDICAL CENTER 1
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-07-01
Business code 622000
Sponsor’s telephone number 4014562018
Plan sponsor’s address 825 CHALKSTONE AVE, PROVIDENCE, RI, 02908

Signature of
Role Plan administrator
Date 2019-01-22
Name of individual signing DAVID HIRSCH
Valid signature Filed with authorized/valid electronic signature
ROGER WILLIAMS MEDICAL CENTER TAX SHELTERED ANNUITY PROGRAM 2018 050258959 2019-06-11 ROGER WILLIAMS MEDICAL CENTER 0
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1985-01-01
Business code 622000
Sponsor’s telephone number 4014562018
Plan sponsor’s address 825 CHALKSTONE AVE, PROVIDENCE, RI, 02908

Signature of
Role Plan administrator
Date 2019-06-11
Name of individual signing DAVID HIRSCH
Valid signature Filed with authorized/valid electronic signature
ROGER WILLIAMS MEDICAL CENTER TAX SHELTERED ANNUITY PROGRAM 2017 050258959 2018-10-03 ROGER WILLIAMS MEDICAL CENTER 0
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1985-01-01
Business code 622000
Sponsor’s telephone number 4014562018
Plan sponsor’s address 825 CHALKSTONE AVE, PROVIDENCE, RI, 02908

Signature of
Role Plan administrator
Date 2018-10-03
Name of individual signing DAVID HIRSCH
Valid signature Filed with authorized/valid electronic signature
ROGER WILLIAMS MEDICAL CENTER TAX SHELTERED ANNUITY PROGRAM 2016 050258959 2017-10-04 ROGER WILLIAMS MEDICAL CENTER 0
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1985-01-01
Business code 622000
Sponsor’s telephone number 4014562018
Plan sponsor’s address 825 CHALKSTONE AVE, PROVIDENCE, RI, 02908

Signature of
Role Plan administrator
Date 2017-10-04
Name of individual signing DAVID HIRSCH
Valid signature Filed with authorized/valid electronic signature
ROGER WILLIAMS MEDICAL CENTER TAX SHELTERED ANNUITY PROGRAM 2015 050258959 2016-10-12 ROGER WILLIAMS MEDICAL CENTER 0
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1985-01-01
Business code 622000
Sponsor’s telephone number 4014562018
Plan sponsor’s address 825 CHALKSTONE AVE, PROVIDENCE, RI, 02908

Signature of
Role Plan administrator
Date 2016-10-12
Name of individual signing DANIEL J. RYAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CT CORPORATION SYSTEM Agent 450 VETERANS MEMORIAL PARKWAY SUITE 7A, EAST PROVIDENCE, RI, 02914, USA

Filings

Number Name File Date
202450330700 Annual Report 2024-04-08
202333589580 Annual Report 2023-04-21
202214639920 Annual Report 2022-04-13
202102292590 Annual Report 2021-09-29
202056096820 Annual Report 2020-09-18
201922782450 Annual Report 2019-10-04
201877892970 Annual Report 2018-09-20
201863120610 Statement of Abandonment of Use of Fictitious Business Name 2018-04-30
201750283330 Annual Report 2017-09-22
201628547560 Annual Report - Amended 2016-12-05

Related by officers

CT CORPORATION SYSTEM

Mason Industries of R.I., Inc. ABANCO Management Corp. HEALTHCARE TRANSPORTATION SYSTEM, INC. W.C. Stumbo Company HUDSON MEDICAL PRODUCTS, INC. ACORN INSULATED WIRE COMPANY, INC. ADAMS DRUG CO. OF BROAD STREET, INC. ADAMS DRUG CO. OF EDGEWOOD, INC. ADAMS DRUG CO. OF SMITHFIELD, INC. ADAMS DRUG CO. OF TIVERTON, INC.

Related by address

3824 HUGHES AVE., CULVER CITY, CA, 90232, USA

PROSPECT CHARTERCARE SJHSRI, LLC PROSPECT CHARTERCARE PHYSICIANS, LLC Prospect Health Services RI, Inc. PROSPECT CHARTERCARE ANCILLARY SERVICES, LLC PROSPECT EAST HOSPITAL ADVISORY SERVICES, LLC Prospect ACO Northeast, LLC

Date of last update: 17 Oct 2024

Sources: Rhode Island Department of State

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