| Name: | Primary and Psychiatric Integrated Care, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 02 Jul 2020 (5 years ago) |
| Date of Dissolution: | 12 Sep 2023 (2 years ago) |
| Date of Status Change: | 12 Sep 2023 (2 years ago) |
| Identification Number: | 001709448 |
| ZIP code: | 02917 |
| County: | Providence County |
| Principal Address: | 5 ROGLER FARM ROAD, SMITHFIELD, RI, 02917, USA |
| Purpose: | APRN CNP FAMILY INDIVIDUAL LIFESPAN PSYCHIATRIC MEDICATION MANAGEMENT |
NAICS
621399 Offices of All Other Miscellaneous Health PractitionersThis U.S. industry comprises establishments of independent health practitioners (except physicians; dentists; chiropractors; optometrists; mental health specialists; physical, occupational, and speech therapists; audiologists; and podiatrists). 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 | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508483694 | 2020-07-06 | 2021-12-16 | 215 LEGRIS AVE, WEST WARWICK, RI, 028932937, US | 215 LEGRIS AVE, WEST WARWICK, RI, 028932937, US | |||||||||||||||||||
|
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| Phone | +1 401-234-6685 |
| Fax | 4012509703 |
Authorized person
| Name | HOLLIE ANN COLUCCI |
| Role | CEO |
| Phone | 4012346685 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MICHAEL COLUCCI | Agent | 16 ANN DRIVE, JOHNSTON, RI, 02919, USA |
| Name | Role | Address |
|---|---|---|
| HOLLIE A COLUCCI | CEO | 5 ROGLER FARM ROAD SMITHFIELD, RI 02917 USA |
| Number | Name | File Date |
|---|---|---|
| 202341540850 | Revocation Certificate For Failure to File the Annual Report for the Year | 2023-09-12 |
| 202338217910 | Revocation Notice For Failure to File An Annual Report | 2023-06-19 |
| 202331890660 | Statement of Change of Registered/Resident Agent | 2023-03-28 |
| 202330849290 | Revocation Notice For Failure to Maintain a Registered Agent | 2023-03-15 |
| 202327082260 | Agent Resigned | 2023-01-31 |
| 202221305960 | Annual Report | 2022-07-15 |
| 202220252760 | Revocation Notice For Failure to File An Annual Report | 2022-06-27 |
| 202184855320 | Annual Report | 2021-01-07 |
| 202044051040 | Articles of Incorporation | 2020-07-02 |
Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
