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Green Line Apothecary of Providence LLC

Company Details

Name: Green Line Apothecary of Providence LLC
Jurisdiction: Rhode Island
Entity type: Domestic Limited Liability Company
Status: Activ
Date of Organization in Rhode Island: 21 Aug 2018 (7 years ago)
Identification Number: 001687513
ZIP code: 02904
County: Providence County
Purpose: PHARMACY AND SODA FOUNTAIN
Principal Address: Google Maps Logo 905 N MAIN ST, PROVIDENCE, RI, 02904, USA
Mailing Address: Google Maps Logo 245 MAIN ST, WAKEFIELD, RI, 02879, USA

Contact Details

Phone +1 401-633-8100

Industry & Business Activity

NAICS

446110 Pharmacies and Drug Stores

This industry comprises establishments known as pharmacies and drug stores engaged in retailing prescription or nonprescription drugs and medicines. Learn more at the U.S. Census Bureau

Agent

Name Role Address
KENNETH PROCACCIANTI Agent 245 MAIN ST, WAKEFIELD, RI, 02879, USA

National Provider Identifier

NPI Number:
1750862983
Certification Date:
2023-09-15

Authorized Person:

Name:
CHRISTINA PROCACCIANTI
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
3336C0003X - Community/Retail Pharmacy
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
831654989
Plan Year:
2023
Number Of Participants:
18
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
35
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
52
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
39
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
25
Sponsors Telephone Number:

Licenses

License No License Type Status Date Issued Expiration Date
PHA00667 Pharmacy -Retail Active 2018-09-19 2025-09-30

Filings

Number Name File Date
202449290170 Annual Report 2024-03-25
202327438580 Annual Report 2023-02-03
202220807960 Annual Report 2022-07-07
202219440800 Revocation Notice For Failure to File An Annual Report 2022-06-22
202101687720 Annual Report 2021-09-17

Expenditures

Agency Date Program Subprogram Amount
Department of Labor and Training 2023-03-17 WORKFORCE DEVELOPMENT SERVICES JTPA & OTHER TRAINING PROGRAMS 8176.14
Department of Labor and Training 2023-01-13 WORKFORCE DEVELOPMENT SERVICES JTPA & OTHER TRAINING PROGRAMS 5796.84

USAspending Awards / Financial Assistance

Date:
2020-04-28
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
95861.00
Total Face Value Of Loan:
95861.00
Date:
2018-12-06
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES WHICH ARE UNABLE TO OBTAIN FINANCING IN THE PRIVATE CREDIT MARKETPLACE
Obligated Amount:
0.00
Face Value Of Loan:
825700.00
Total Face Value Of Loan:
825700.00
Date:
2018-09-26
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES WHICH ARE UNABLE TO OBTAIN FINANCING IN THE PRIVATE CREDIT MARKETPLACE
Obligated Amount:
0.00
Face Value Of Loan:
-900000.00
Total Face Value Of Loan:
0.00
Date:
2018-09-21
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES WHICH ARE UNABLE TO OBTAIN FINANCING IN THE PRIVATE CREDIT MARKETPLACE
Obligated Amount:
0.00
Face Value Of Loan:
-900000.00
Total Face Value Of Loan:
0.00

Paycheck Protection Program

Date Approved:
2020-04-28
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
95861
Current Approval Amount:
95861
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
96719.81

Date of last update: 02 Jun 2025

Sources: Rhode Island Department of State