| Name: | Magellan Healthcare Provider Group, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 14 Dec 2022 (2 years ago) |
| Identification Number: | 001749786 |
| Place of Formation: | MARYLAND |
| Purpose: | PROVIDE BEHAVIORAL HEALTH SERVICES |
| Principal Address: |
8621 ROBERT FULTON DRIVE, COLUMBIA, MD, 21046, USA
|
NAICS
524210 Insurance Agencies and BrokeragesThis industry comprises establishments primarily engaged in acting as agents (i.e., brokers) in selling annuities and insurance policies. Learn more at the U.S. Census Bureau
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | 222 JEFFERSON BOULEVARD SUITE 200, WARWICK, RI, 02888, USA |
| Name | Role | Address |
|---|---|---|
| DERRICK DUKE | PRESIDENT | 8621 ROBERT FULTON DRIVE COLUMBIA, MD 21046 USA |
| Name | Role | Address |
|---|---|---|
| CAROLINE BECKER | ASSISTANT SECRETARY | 8621 ROBERT FULTON DRIVE COLUMBIA, MD 21046 USA |
| Name | Role | Address |
|---|---|---|
| CAMILLE GUILLOT | ASST. TREASURER | 8621 ROBERT FUTLON DRIVE COLUMBIA, MD 21046 USA |
| Name | Role | Address |
|---|---|---|
| DERRICK DUKE | DIRECTOR | 8621 ROBERT FULTON DRIVE COLUMBIA, MD 21046 USA |
| ERIKA ROSE | DIRECTOR | 8621 ROBERT FULTON DR. COLUMBIA, MD 21046 USA |
| Name | Role | Address |
|---|---|---|
| ERIKA ROSE | SECRETARY | 8621 ROBERT FULTON DR. COLUMBIA, MD 21046 USA |
| Name | Role | Address |
|---|---|---|
| ERIK DAUGHERTY | CFO | 8621 ROBERT FULTON DR. COLUMBIA, MD 21046 USA |
| Number | Name | File Date |
|---|---|---|
| 202452358450 | Annual Report | 2024-04-24 |
| 202334037800 | Annual Report | 2023-04-26 |
| 202225192520 | Application for Certificate of Authority | 2022-12-14 |
| 202571567540 | Annual Report | 2025-04-28 |
Date of last update: 15 May 2025
Sources: Rhode Island Department of State
