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HINES DERMATOLOGY ASSOCIATES, INC.

Company Details

Name: HINES DERMATOLOGY ASSOCIATES, INC.
Jurisdiction: Rhode Island
Entity type: Foreign Corporation
Status: Revoked Entity
Date of Organization in Rhode Island: 19 Jan 2021 (4 years ago)
Date of Dissolution: 12 Oct 2022 (3 years ago)
Date of Status Change: 12 Oct 2022 (3 years ago)
Identification Number: 001717952
Place of Formation: MASSACHUSETTS
Principal Address: 555 PLEASANT STREET, ATTLEBORO, MA, 02703, USA
Purpose: DERMATOLOGY PRACTICE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HINES DERMATOLOGY ASSOCIATES PROFIT SHARING RETIREMENT PLAN 2018 050406622 2019-09-06 HINES DERMATOLOGY ASSOCIATES 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-12-27
Business code 621111
Sponsor’s telephone number 5082221976
Plan sponsor’s address 176 PRESIDENT AVENUE, PROVIDENCE, RI, 029064616
HINES DERMATOLOGY ASSOCIATES PROFIT SHARING RETIREMENT PLAN 2017 050406622 2018-08-21 HINES DERMATOLOGY ASSOCIATES 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-12-27
Business code 621111
Sponsor’s telephone number 5082221976
Plan sponsor’s address 176 PRESIDENT AVENUE, PROVIDENCE, RI, 029064616
HINES DERMATOLOGY ASSOCIATES PROFIT SHARING RETIREMENT PLAN 2016 050406622 2017-08-14 HINES DERMATOLOGY ASSOCIATES 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-12-27
Business code 621111
Sponsor’s telephone number 5082221976
Plan sponsor’s address 176 PRESIDENT AVENUE, PROVIDENCE, RI, 029064616
HINES DERMATOLOGY ASSOCIATES PROFIT SHARING RETIREMENT PLAN 2015 050406622 2016-06-08 HINES DERMATOLOGY ASSOCIATES 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-12-27
Business code 621111
Sponsor’s telephone number 5082221976
Plan sponsor’s address 176 PRESIDENT AVENUE, PROVIDENCE, RI, 029064616

Plan administrator’s name and address
Administrator’s EIN 050406622
Plan administrator’s name HINES DERMATOLOGY ASSOCIATES
Plan administrator’s address 176 PRESIDENT AVENUE, PROVIDENCE, RI, 029064616
Administrator’s telephone number 5082221976
HINES DERMATOLOGY ASSOCIATES PROFIT SHARING RETIREMENT PLAN 2014 050406622 2015-07-16 HINES DERMATOLOGY ASSOCIATES 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-12-27
Business code 621111
Sponsor’s telephone number 5082221976
Plan sponsor’s address 176 PRESIDENT AVENUE, PROVIDENCE, RI, 029064616

Plan administrator’s name and address
Administrator’s EIN 050406622
Plan administrator’s name HINES DERMATOLOGY ASSOCIATES
Plan administrator’s address 176 PRESIDENT AVENUE, PROVIDENCE, RI, 029064616
Administrator’s telephone number 5082221976

Signature of
Role Plan administrator
Date 2015-07-16
Name of individual signing YVONNE HINES
Valid signature Filed with authorized/valid electronic signature
HINES DERMATOLOGY ASSOCIATES PROFIT SHARING RETIREMENT PLAN 2013 050406622 2014-07-22 HINES DERMATOLOGY ASSOCIATES 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-12-27
Business code 621111
Sponsor’s telephone number 5082221976
Plan sponsor’s address 176 PRESIDENT AVENUE, PROVIDENCE, RI, 029064616

Plan administrator’s name and address
Administrator’s EIN 050406622
Plan administrator’s name HINES DERMATOLOGY ASSOCIATES
Plan administrator’s address 176 PRESIDENT AVENUE, PROVIDENCE, RI, 029064616
Administrator’s telephone number 5082221976

Signature of
Role Plan administrator
Date 2014-07-22
Name of individual signing YVONNE HINES
Valid signature Filed with authorized/valid electronic signature
HINES DERMATOLOGY ASSOCIATES PROFIT SHARING RETIREMENT PLAN 2012 050406622 2013-09-27 HINES DERMATOLOGY ASSOCIATES 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-12-27
Business code 621111
Sponsor’s telephone number 5082221976
Plan sponsor’s address 176 PRESIDENT AVENUE, PROVIDENCE, RI, 029064616

Plan administrator’s name and address
Administrator’s EIN 050406622
Plan administrator’s name HINES DERMATOLOGY ASSOCIATES
Plan administrator’s address 176 PRESIDENT AVENUE, PROVIDENCE, RI, 029064616
Administrator’s telephone number 5082221976

Signature of
Role Plan administrator
Date 2013-09-27
Name of individual signing YVONNE HINES
Valid signature Filed with authorized/valid electronic signature
HINES DERMATOLOGY ASSOCIATES PROFIT SHARING RETIREMENT PLAN 2011 050406622 2012-07-03 HINES DERMATOLOGY ASSOCIATES 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-12-27
Business code 621111
Sponsor’s telephone number 5082221976
Plan sponsor’s address 176 PRESIDENT AVENUE, PROVIDENCE, RI, 029064616

Plan administrator’s name and address
Administrator’s EIN 050406622
Plan administrator’s name HINES DERMATOLOGY ASSOCIATES
Plan administrator’s address 176 PRESIDENT AVENUE, PROVIDENCE, RI, 029064616
Administrator’s telephone number 5082221976

Signature of
Role Plan administrator
Date 2012-07-03
Name of individual signing YVONNE HINES
Valid signature Filed with authorized/valid electronic signature
HINES DERMATOLOGY ASSOC P S R P 2009 050406622 2011-06-08 HINES DERMATOLOGY ASSOCIATES No data
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-12-27
Business code 621111
Sponsor’s telephone number 5082221976
Plan sponsor’s mailing address 176 PRESIDENT AVENUE, PROVIDENCE, RI, 02906
Plan sponsor’s address 176 PRESIDENT AVENUE, PROVIDENCE, RI, 02906

Plan administrator’s name and address
Administrator’s EIN 050406622
Plan administrator’s name HINES DERMATOLOGY ASSOCIATES
Plan administrator’s address 176 PRESIDENT AVENUE, PROVIDENCE, RI, 02906
Administrator’s telephone number 5082221976

Agent

Name Role Address
YVONNE C. HINES Agent 235 PLAIN STREET UNIT 101B, PROVIDENCE, RI, 02905, USA

PRESIDENT

Name Role Address
YVONNE C. HINES PRESIDENT 555 PLEASANT STREET ATTLEBORO, MA 02703 USA

Filings

Number Name File Date
202223981810 Revocation Certificate For Failure to File the Annual Report for the Year 2022-10-12
202220272470 Revocation Notice For Failure to File An Annual Report 2022-06-27
202187161040 Application for Certificate of Authority 2021-01-19

Related by officers

YVONNE C. HINES

Hines Dermatology Associates, Inc. K.C. REALTY, LLC

Related by address

555 PLEASANT STREET, ATTLEBORO, MA, 02703, USA

K.C. REALTY, LLC

Date of last update: 28 Oct 2024

Sources: Rhode Island Department of State

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