| Name: | Interventional and Functional Pain Center, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 07 Sep 2018 (6 years ago) |
| Identification Number: | 001688007 |
| ZIP code: | 02920 |
| County: | Providence County |
| Principal Address: | 1150 RESERVOIR AVENUE SUITE 200, CRANSTON, RI, 02920, USA |
| Purpose: | THIS IS A MEDICAL OFFICE THAT EVALUATES AND TREAT PATIENTS WITH MEDICAL CONDITIONS INVOLVING PAIN IN THE SPINE, JOINT, MUSCLES, TENDONS, LIGAMENTS, AND NERVES AREAS. |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| Fictitious names: |
Pain Center of Rhode Island (trading name, 2022-05-12 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356127773 | 2023-09-01 | 2023-09-01 | 1150 RESERVOIR AVE STE 200, CRANSTON, RI, 029206043, US | 1150 RESERVOIR AVE STE 200, CRANSTON, RI, 029206043, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 347-310-0149 |
Authorized person
| Name | JUAN CARLOS MIRT |
| Role | OWNER |
| Phone | 4016486100 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JUAN CARLOS MIRT | Agent | 55 OSPREY DRIVE, EAST GREENWICH, RI, 02818, USA |
| Name | Role | Address |
|---|---|---|
| BLANKI CHERUBINI | PRESIDENT | 1150 RESERVOIR AVE STE 200 CRANSTON, RI 02920 US |
| Name | Role | Address |
|---|---|---|
| JUAN CARLOS MIRT | VICE PRESIDENT | 1150 RESERVOIR AVE STE 200 CRANSTON, RI 02920 US |
| Number | Name | File Date |
|---|---|---|
| 202455441050 | Annual Report | 2024-06-07 |
| 202326362110 | Annual Report | 2023-01-21 |
| 202217285700 | Fictitious Business Name Statement | 2022-05-12 |
| 202212968770 | Annual Report | 2022-03-16 |
| 202185236920 | Annual Report | 2021-01-08 |
| 202033564670 | Annual Report | 2020-02-03 |
| 201920555560 | Annual Report | 2019-09-23 |
| 201907265710 | Revocation Notice For Failure to File An Annual Report | 2019-07-24 |
| 201876819130 | Articles of Incorporation | 2018-09-07 |
Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
