| Name: | Family Doctor Plus - RI, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 12 Aug 2014 (11 years ago) |
| Date of Dissolution: | 29 Dec 2020 (4 years ago) |
| Date of Status Change: | 29 Dec 2020 (4 years ago) |
| Identification Number: | 000971163 |
| ZIP code: | 02879 |
| County: | Washington County |
| Principal Address: | 553 KINGSTOWN ROAD, WAKEFIELD, RI, 02879, USA |
| Purpose: | WALK-IN CLINIC |
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 | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386041507 | 2014-12-03 | 2016-01-28 | 553 KINGSTOWN RD, WAKEFIELD, RI, 028793600, US | 553 KINGSTOWN RD, WAKEFIELD, RI, 028793600, US | |||||||||||||||
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| Phone | +1 401-304-9111 |
| Fax | 4012840625 |
Authorized person
| Name | MICHAEL J WEAVER |
| Role | MEDICAL DIRECTOR |
| Phone | 4013049111 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JOSEPH HOEFFERLE, ESQ. | Agent | 47 WOOD AVENUE, BARRINGTON, RI, 02806, USA |
| Name | Role | Address |
|---|---|---|
| CHERI NOLAN | MANAGER | 553 KINSTOWN ROAD WAKEFIELD, RI 02879 USA |
| WILLIAM WELTER | MANAGER | 553 KINGSTOWN ROAD WAKEFIELD, RI 02879 USA |
| Number | Name | File Date |
|---|---|---|
| 202082460590 | Revocation Certificate For Failure to File the Annual Report for the Year | 2020-12-29 |
| 202045303120 | Revocation Notice For Failure to File An Annual Report | 2020-07-20 |
| 201880569560 | Annual Report | 2018-10-31 |
| 201880568770 | Statement of Change of Registered/Resident Agent | 2018-10-31 |
| 201752974650 | Statement of Change of Registered/Resident Agent | 2017-11-03 |
| 201752554690 | Annual Report | 2017-10-30 |
| 201752555200 | Annual Report | 2017-10-30 |
| 201752554410 | Reinstatement | 2017-10-30 |
| 201746407760 | Revocation Certificate For Failure to File the Annual Report for the Year | 2017-06-27 |
| 201739759670 | Revocation Notice For Failure to File An Annual Report | 2017-04-06 |
Date of last update: 19 Oct 2024
Sources: Rhode Island Department of State
