| Name: | Osteopathic Family Medicine, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 13 Sep 2013 (11 years ago) |
| Identification Number: | 000834608 |
| ZIP code: | 02892 |
| County: | Washington County |
| Principal Address: | 39 GREENS END LANE, WEST KINGSTON, RI, 02892, USA |
| Mailing Address: | 39 GREENS END LN SUITE 1B, WEST KINGSTON, RI, 02892, USA |
| Purpose: | PHYSICIANS OFFICE |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861811358 | 2014-04-11 | 2017-01-10 | 55 CHERRY LN, SUITE 1B, WAKEFIELD, RI, 028793617, US | 55 CHERRY LN, SUITE 1B, WAKEFIELD, RI, 028793617, US | |||||||||||||||||||||||||
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| Phone | +1 401-284-4555 |
| Fax | 8887817202 |
Authorized person
| Name | DR. AARON WILLIAM WAY |
| Role | OWNER/PHYSICIAN |
| Phone | 4012844555 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | DO00631 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | INDIVIDUAL NPI |
| Number | 1356497176 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| AARON WAY | Agent | 39 GREENS END LANE, WEST KINGSTON, RI, 02892, USA |
| Number | Name | File Date |
|---|---|---|
| 202447240870 | Annual Report | 2024-02-26 |
| 202326172700 | Annual Report | 2023-01-19 |
| 202209506770 | Annual Report | 2022-02-06 |
| 202101733580 | Annual Report | 2021-09-19 |
| 202071479730 | Annual Report | 2020-11-04 |
| 202031229300 | Annual Report | 2020-01-06 |
| 202031230900 | Annual Report | 2020-01-06 |
| 202031231060 | Annual Report | 2020-01-06 |
| 202031231240 | Annual Report | 2020-01-06 |
| 202031227630 | Reinstatement | 2020-01-06 |
Date of last update: 18 Oct 2024
Sources: Rhode Island Department of State
