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  5. Blackstone Valley Foot and Ankle, Inc.

Blackstone Valley Foot and Ankle, Inc.

Company Details

Name: Blackstone Valley Foot and Ankle, Inc.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Activ
Date of Organization in Rhode Island: 01 Oct 2014 (10 years ago)
Identification Number: 000990887
ZIP code: 02861
County: Providence County
Principal Address: 345 ARMISTIC BLVD, PAWTUCKET, RI, 02861, USA
Purpose: PRACTICE OF PODIATRIC MEDICINE AND SURGERY
NAICS: 621391 - Offices of Podiatrists

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1720482193 2014-10-14 2017-04-24 345 ARMISTICE BLVD, PAWTUCKET, RI, 028612429, US 345 ARMISTICE BLVD, PAWTUCKET, RI, 028612429, US

Contacts
Phone +1 401-725-5576
Fax 4017252640

Authorized person
Name DR. JOSEPH KEVIN DOMENICO
Role OWNER
Phone 4017255576

Taxonomy
Taxonomy Code 213ES0103X - Foot & Ankle Surgery Podiatrist
License Number DPM00327
State RI
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLACKSTONE VALLEY FOOT AND ANKLE, INC. 401(K) PLAN 2023 471995515 2024-05-30 BLACKSTONE VALLEY FOOT AND ANKLE, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621391
Sponsor’s telephone number 4017255576
Plan sponsor’s address 345 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02861

Signature of
Role Plan administrator
Date 2024-05-30
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-05-30
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature
BLACKSTONE VALLEY FOOT AND ANKLE, INC. 401(K) PLAN 2022 471995515 2023-05-26 BLACKSTONE VALLEY FOOT AND ANKLE, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621391
Sponsor’s telephone number 4017255576
Plan sponsor’s address 345 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02861

Signature of
Role Plan administrator
Date 2023-05-26
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-05-26
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature
BLACKSTONE VALLEY FOOT AND ANKLE, INC. 401(K) PLAN 2021 471995515 2022-05-12 BLACKSTONE VALLEY FOOT AND ANKLE, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621391
Sponsor’s telephone number 4017255576
Plan sponsor’s address 345 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02861

Signature of
Role Plan administrator
Date 2022-05-12
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-05-12
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature
BLACKSTONE VALLEY FOOT AND ANKLE, INC. 401(K) PLAN 2020 471995515 2021-06-18 BLACKSTONE VALLEY FOOT AND ANKLE, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621391
Sponsor’s telephone number 4017255576
Plan sponsor’s address 345 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02861

Signature of
Role Plan administrator
Date 2021-06-18
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-06-18
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature
BLACKSTONE VALLEY FOOT AND ANKLE, INC. 401(K) PLAN 2019 471995515 2020-07-02 BLACKSTONE VALLEY FOOT AND ANKLE, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621391
Sponsor’s telephone number 4017255576
Plan sponsor’s address 345 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02861

Signature of
Role Plan administrator
Date 2020-07-02
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-02
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature
BLACKSTONE VALLEY FOOT AND ANKLE, INC. 401(K) PLAN 2018 471995515 2019-06-06 BLACKSTONE VALLEY FOOT AND ANKLE, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621391
Sponsor’s telephone number 4017255576
Plan sponsor’s address 345 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02861

Signature of
Role Plan administrator
Date 2019-06-06
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-06-06
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature
BLACKSTONE VALLEY FOOT AND ANKLE, INC. 401(K) PLAN 2017 471995515 2018-05-29 BLACKSTONE VALLEY FOOT AND ANKLE, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621391
Sponsor’s telephone number 4017255576
Plan sponsor’s address 345 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02861

Signature of
Role Plan administrator
Date 2018-05-29
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-29
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature
BLACKSTONE VALLEY FOOT AND ANKLE, INC. 401(K) PLAN 2016 471995515 2017-08-21 BLACKSTONE VALLEY FOOT AND ANKLE, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621391
Sponsor’s telephone number 4017255576
Plan sponsor’s address 345 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02861

Signature of
Role Plan administrator
Date 2017-08-21
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-21
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature
BLACKSTONE VALLEY FOOT AND ANKLE, INC. 401(K) PLAN 2015 471995515 2016-06-15 BLACKSTONE VALLEY FOOT AND ANKLE, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621391
Sponsor’s telephone number 4017255576
Plan sponsor’s address 345 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02861

Signature of
Role Plan administrator
Date 2016-06-15
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-06-15
Name of individual signing JOSEPH DOMENICO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
JONATHAN V. KALANDER, ESQ. Agent 931 JEFFERSON BOULEVARD SUITE 2004, WARWICK, RI, 02886, USA

PRESIDENT

Name Role Address
JOSEPH DOMENICO PRESIDENT 345 ARMISTICE BLVD PAWTUCKET, RI 02861 USA

DIRECTOR

Name Role Address
JOSEPH DOMENICO DIRECTOR 345 ARMISTICE BLVD PAWTUCKET, RI 02861 USA

Filings

Number Name File Date
202448455930 Annual Report 2024-03-13
202330048350 Annual Report 2023-03-06
202213405490 Annual Report 2022-03-24
202193480160 Annual Report 2021-03-03
202036486320 Annual Report 2020-03-18
201986964340 Annual Report 2019-02-19
201859276990 Annual Report 2018-02-28
201734807330 Annual Report 2017-02-27
201693386550 Annual Report 2016-02-29
201557889780 Annual Report 2015-03-21

Related by officers

JONATHAN V. KALANDER, ESQ.

C & D, Inc. DPM Investments, Inc. Everson Construction, Inc. ERNEST P. MENNILLO, M.D., INC. GOODWIN REALTY, INC. EXETER COUNTRY CLUB, INC. HARMONY PATTERN & CASTING CO., INC. Systems Resource Management, Inc. R.I. REFRIGERATION SUPPLY CO., INC. Perry-McStay Funeral Home, Inc.

JOSEPH DOMENICO

345 ARMISTICE, LLC

Related by address

No related companies by address

Date of last update: 19 Oct 2024

Sources: Rhode Island Department of State

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