| Name: | Wound Care Specialists of RI, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 11 Mar 2020 (5 years ago) |
| Identification Number: | 001705235 |
| ZIP code: | 02882 |
| County: | Washington County |
| Principal Address: | 91 POINT JUDITH, NARRAGANSETT, RI, 02882, USA |
| Mailing Address: | 76 BATTERSON PARK ROAD SUITE 106, FARMINGTON, CT, 06032, USA |
| Purpose: | WOUND CARE MEDICAL PRACTICE PROVIDING CARE TO NURSING HOME PATIENTS |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881211738 | 2020-06-26 | 2023-10-23 | 76 BATTERSON PARK RD STE 106, FARMINGTON, CT, 060322571, US | 10 DORRANCE ST STE 700, PROVIDENCE, RI, 029032014, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 203-598-6045 |
| Fax | 2038790834 |
Authorized person
| Name | MR. JONATHAN BRENES |
| Role | CHIEF OPERATING OFFICER |
| Phone | 2035986045 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208600000X - Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| ROBERT BRENES | Agent | 91 POINT JUDITH RD #357, NARRAGANSETT, RI, 02882, USA |
| Number | Name | File Date |
|---|---|---|
| 202460650120 | Annual Report | 2024-10-16 |
| 202460649890 | Annual Report | 2024-10-16 |
| 202460649700 | Annual Report | 2024-10-16 |
| 202460649520 | Annual Report | 2024-10-16 |
| 202460650210 | Reinstatement | 2024-10-16 |
| 202210493300 | Revocation Certificate For Failure to File the Annual Report for the Year | 2022-02-14 |
| 202106183100 | Revocation Notice For Failure to File An Annual Report | 2021-12-03 |
| 202192574950 | Statement of Change of Registered/Resident Agent | 2021-02-23 |
| 202035068130 | Articles of Organization | 2020-03-11 |
Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
