| Name: | OCEAN STATE PRIMARY CARE CENTER OF COVENTRY, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 02 Apr 2015 (10 years ago) |
| Identification Number: | 001100066 |
| ZIP code: | 02816 |
| County: | Kent County |
| Principal Address: | 982 TIOGUE AVENUE, COVENTRY, RI, 02816, USA |
| Purpose: | PROVIDE URGENT MEDICAL CARE SERVICES |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134514276 | 2015-04-06 | 2017-10-11 | 982 TIOGUE AVE, COVENTRY, RI, 028166116, US | 982 TIOGUE AVE, COVENTRY, RI, 028166116, US | |||||||||||||||||||||||||||
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| Phone | +1 401-821-6800 |
| Fax | 4018218513 |
Authorized person
| Name | JONATHAN H. MARTIN |
| Role | MANAGING PARTNER |
| Phone | 4018216800 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 363A00000X - Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | 222 JEFFERSON BOULEVARD SUITE 200, WARWICK, RI, 02888, USA |
| Name | Role | Address |
|---|---|---|
| BRENT ASPLIN MD | MANAGER | 125 S. CLARK ST., STE 900 CHICAGO, IL 60603 USA |
| Number | Name | File Date |
|---|---|---|
| 202453806950 | Annual Report | 2024-05-02 |
| 202334664060 | Annual Report | 2023-04-29 |
| 202216824900 | Annual Report | 2022-05-04 |
| 202209781870 | Statement of Change of Registered/Resident Agent | 2022-02-09 |
| 202104087770 | Annual Report | 2021-10-28 |
| 202075398280 | Annual Report | 2020-11-16 |
| 202032774250 | Annual Report | 2020-01-21 |
| 202032775130 | Statement of Change of Registered/Resident Agent | 2020-01-21 |
| 201879611740 | Annual Report - Amended | 2018-10-17 |
| 201879527410 | Annual Report | 2018-10-16 |
Date of last update: 20 Oct 2024
Sources: Rhode Island Department of State
