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HAROLD J. WANEBO, MD, LLC

Company Details

Name: HAROLD J. WANEBO, MD, LLC
Jurisdiction: Rhode Island
Entity type: Domestic Limited Liability Company
Status: Revoked Entity
Date of Organization in Rhode Island: 30 Jan 2014 (11 years ago)
Date of Dissolution: 14 Feb 2022 (3 years ago)
Date of Status Change: 14 Feb 2022 (3 years ago)
Identification Number: 000897822
ZIP code: 02809
County: Bristol County
Purpose: TO OPERATE A MEDICAL OFFICE
Principal Address: Google Maps Logo 116 POPPASQUASH ROAD, BRISTOL, RI, 02809, USA

Industry & Business Activity

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

Agent

Name Role Address
STEPHEN D. ZUBIAGO, ESQ. Agent NIXON PEABODY LLP ONE CITIZENS PLAZA SUITE 500, PROVIDENCE, RI, 02903, USA

MANAGER

Name Role Address
HAROLD J. WANEBO MD MANAGER 116 POPPASQUASH ROAD BRISTOL, RI 02809 USA

National Provider Identifier

NPI Number:
1740609981

Authorized Person:

Name:
DR. HAROLD J WANEBO
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
2086X0206X - Surgical Oncology Physician
Is Primary:
Yes

Contacts:

Fax:
4019431958

Filings

Number Name File Date
202210280720 Revocation Certificate For Failure to File the Annual Report for the Year 2022-02-14
202105991850 Revocation Notice For Failure to File An Annual Report 2021-12-03
202071890120 Annual Report 2020-10-28
201924447780 Annual Report 2019-10-15
201879580280 Annual Report 2018-10-16

Date of last update: 31 May 2025

Sources: Rhode Island Department of State