| Name: | Rhode Island Health Group, P.C. |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 20 Jul 2020 (5 years ago) |
| Date of Dissolution: | 12 Oct 2022 (2 years ago) |
| Date of Status Change: | 12 Oct 2022 (2 years ago) |
| Identification Number: | 001710975 |
| ZIP code: | 02896 |
| County: | Providence County |
| Principal Address: | 63-65 EDDIE DOWLING HIGHWAY, NORTH SMITHFIELD, RI, 02896, USA |
| Purpose: | MEDICAL PRACTICE |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982216974 | 2020-08-20 | 2023-10-10 | 63 EDDIE DOWLING HWY STE 1, NORTH SMITHFIELD, RI, 028967322, US | 65 EDDIE DOWLING HWY, NORTH SMITHFIELD, RI, 028967305, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 401-597-5353 |
| Fax | 4017694555 |
Authorized person
| Name | MUHAMMAD IMRAN CHAUDRY |
| Role | CHIEF EXECUTIVE OFFICER |
| Phone | 4015975353 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 710001102 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| NASIR BHATTI, M.D. | Agent | 63-65 EDDIE DOWLING HIGHWAY, NORTH SMITHFIELD, RI, 02896, USA |
| Name | Role | Address |
|---|---|---|
| NASIR BHATTI MD | PRESIDENT | 63-65 EDDIE DOWLING HIGHWAY NORTH SMITHFIELD, RI 02896 USA |
| Name | Role | Address |
|---|---|---|
| SYED IFTIKHAR HUSSAIN MD | SECRETARY | 63-65 EDDIE DOWLING HIGHWAY NORTH SMITHFIELD, RI 02896 USA |
| Name | Role | Address |
|---|---|---|
| NASIR BHATTI MD | DIRECTOR | 63-65 EDDIE DOWLING HIGHWAY NORTH SMITHFIELD, RI 02896 USA |
| SYED IFTIKHAR HUSSAIN MD | DIRECTOR | 63-65 EDDIE DOWLING HIGHWAY NORTH SMITHFIELD, RI 02896 USA |
| Number | Name | File Date |
|---|---|---|
| 202223973680 | Revocation Certificate For Failure to File the Annual Report for the Year | 2022-10-12 |
| 202220255220 | Revocation Notice For Failure to File An Annual Report | 2022-06-27 |
| 202198506900 | Statement of Change of Registered/Resident Agent | 2021-06-22 |
| 202198506630 | Annual Report | 2021-06-22 |
| 202197047080 | Revocation Notice For Failure to File An Annual Report | 2021-05-19 |
| 202050499410 | Certificate of Correction | 2020-08-28 |
| 202050458390 | Statement of Change of Registered/Resident Agent | 2020-08-28 |
| 202047536490 | Articles of Incorporation | 2020-07-20 |
Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
