| Name: | Purple Shield Medical, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Limited Liability Company |
| Status: | Cancelled |
| Date of Organization in Rhode Island: | 29 Oct 2020 (4 years ago) |
| Date of Dissolution: | 01 Dec 2023 (a year ago) |
| Date of Status Change: | 01 Dec 2023 (a year ago) |
| Identification Number: | 001714609 |
| ZIP code: | 02886 |
| County: | Kent County |
| Place of Formation: | MASSACHUSETTS |
| Principal Address: | 3649 POST RD, WARWICK, RI, 02886, USA |
| Mailing Address: | 107 SONNYS WAY CEDAR, DIGHTON, MA, 02715, USA |
| Purpose: | PROVIDE TRAINING TESTING AND ACCREDIDATION FOR INFECTIOUS DISEASE CONTROL. MEDICAL SOLUTIONS COMPANY |
| NAICS: | 621999 - All Other Miscellaneous Ambulatory Health Care Services |
| Historical names: |
Purple Shield LLC |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801487491 | 2021-01-27 | 2022-03-07 | 3649 POST RD STE 2, WARWICK, RI, 028867236, US | 3649 POST RD STE 2, WARWICK, RI, 028867236, US | |||||||||||||||||||
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| Phone | +1 508-536-2730 |
| Fax | 5086759920 |
Authorized person
| Name | MR. JOSEPH MOSS |
| Role | PRESIDENT |
| Phone | 5087284178 |
Taxonomy
| Taxonomy Code | 2083P0901X - Public Health & General Preventive Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PURPLE SHIELD MEDICAL 81H418 | 2022 | 854135226 | 2024-10-17 | PURPLE SHIELD MEDICAL LLC | 6 | |||||||||||||||||||||||||||||||||||||||||||||||
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| Active participants | 6 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
| Number of participants with account balances as of the end of the plan year | 6 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 6 |
Signature of
| Role | Plan administrator |
| Date | 2024-10-17 |
| Name of individual signing | CAITLYNN FERREIRA |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2024-10-17 |
| Name of individual signing | JOSEPH MOSS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| DANIEL ABRAHAM | Agent | 518 RIVERSIDE DR, TIVERTON, RI, 02878, USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2021-01-06 | Purple Shield LLC | Purple Shield Medical, LLC |
| Number | Name | File Date |
|---|---|---|
| 202343132350 | Certificate of Cancellation | 2023-12-01 |
| 202339065510 | Annual Report | 2023-07-05 |
| 202337014240 | Revocation Notice For Failure to File An Annual Report | 2023-06-16 |
| 202212435920 | Annual Report | 2022-03-08 |
| 202197803190 | Amendment to Application for Registration | 2021-06-04 |
| 202196023760 | Annual Report | 2021-04-28 |
| 202184719280 | Amendment to Application for Registration | 2021-01-06 |
| 202083065000 | Statement of Change of Registered/Resident Agent | 2020-12-30 |
| 202069833320 | Application for Registration | 2020-10-29 |
Date of last update: 28 Oct 2024
Sources: Rhode Island Department of State
