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  5. GREEN LINE APOTHECARY LLC

GREEN LINE APOTHECARY LLC

Company Details

Name: GREEN LINE APOTHECARY LLC
Jurisdiction: Rhode Island
Entity type: Domestic Limited Liability Company
Status: Activ
Date of Organization in Rhode Island: 09 Mar 2015 (10 years ago)
Identification Number: 001081140
ZIP code: 02879
County: Washington County
Principal Address: 245 MAIN STREET, WAKEFIELD, RI, 02879, USA
Purpose: PHARMACY AND SODA FOUNTAIN
NAICS: 446110 - Pharmacies and Drug Stores

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1053975102 2019-04-24 2023-09-15 245 MAIN ST, WAKEFIELD, RI, 028793527, US 245 MAIN ST, WAKEFIELD, RI, 028793527, US

Contacts
Phone +1 401-360-3400

Authorized person
Name CHRISTINA PROCACCIANTI
Role CEO
Phone 4013603200

Taxonomy
Taxonomy Code 3336L0003X - Long Term Care Pharmacy
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GREEN LINE APOTHECARY 401(K) PLAN 2023 473563566 2024-05-24 GREEN LINE APOTHECARY, LLC 92
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 446110
Sponsor’s telephone number 4013603200
Plan sponsor’s address 245 MAIN STREET, WAKEFIELD, RI, 02879

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2024-05-24
Name of individual signing QIAN LIU
Valid signature Filed with authorized/valid electronic signature
GREEN LINE APOTHECARY 401(K) PLAN 2022 473563566 2023-05-26 GREEN LINE APOTHECARY, LLC 74
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 446110
Sponsor’s telephone number 4013603200
Plan sponsor’s address 245 MAIN STREET, WAKEFIELD, RI, 02879

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2023-05-26
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
GREEN LINE APOTHECARY 401(K) PLAN 2021 473563566 2022-07-05 GREEN LINE APOTHECARY, LLC 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 446110
Sponsor’s telephone number 4013603200
Plan sponsor’s address 245 MAIN STREET, WAKEFIELD, RI, 02879

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2022-07-05
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
GREEN LINE APOTHECARY 401(K) PLAN 2020 473563566 2021-07-16 GREEN LINE APOTHECARY, LLC 46
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 446110
Sponsor’s telephone number 4019329626
Plan sponsor’s address 203 MAIN STREET, WAKEFIELD, RI, 02879

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2021-07-15
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature
GREEN LINE APOTHECARY 401(K) PLAN 2019 473563566 2020-05-22 GREEN LINE APOTHECARY, LLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 446110
Sponsor’s telephone number 4019329626
Plan sponsor’s address 203 MAIN STREET, WAKEFIELD, RI, 02879

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2020-05-22
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CHRISTINA PROCACCIANTI Agent 245 MAIN STREET, WAKEFIELD, RI, 02879, USA

Filings

Number Name File Date
202449287170 Annual Report 2024-03-25
202327440150 Annual Report 2023-02-03
202220824200 Annual Report 2022-07-08
202219506560 Revocation Notice For Failure to File An Annual Report 2022-06-22
202101689580 Statement of Change of Registered/Resident Agent Office 2021-09-17
202101689670 Annual Report 2021-09-17
202071505880 Annual Report 2020-11-04
201924449450 Annual Report 2019-10-17
201879852350 Annual Report 2018-10-22
201753165390 Annual Report 2017-11-09

Related by officers

No related officers

Related by address

245 MAIN STREET, WAKEFIELD, RI, 02879, USA

203 MAIN LLC Lineage LLC 905 North Main LLC Town Made LLC Green Line Express LLC

Date of last update: 20 Oct 2024

Sources: Rhode Island Department of State

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