| 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 (7 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. |
| Fictitious names: |
Pain Center of Rhode Island (trading name, 2022-05-12 - ) |
NAICS
621111 Offices of Physicians (except Mental Health Specialists)This U.S. industry comprises establishments of health practitioners having the degree of M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathy) primarily engaged in the independent practice of general or specialized medicine (except psychiatry or psychoanalysis) or surgery. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. Learn more at the U.S. Census Bureau
| 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 | |||||||||||||
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| 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 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 4879438402 | 2021-02-07 | 0165 | PPS | 1150 Reservoir Ave Sute 303, Cranston, RI, 02920 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 4081627808 | 2020-05-27 | 0165 | PPP | 1150 RESERVOIR AVE, CRANSTON, RI, 02920-6043 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
