| 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 (12 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)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 | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 8895047209 | 2020-04-28 | 0165 | PPP | 55 CHERRY LN Ste B, WAKEFIELD, RI, 02879-3617 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 18 Oct 2024
Sources: Rhode Island Department of State
