| Name: | Lucas Medical LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 30 Sep 2024 (4 months ago) |
| Identification Number: | 001779773 |
| ZIP code: | 02806 |
| County: | Bristol County |
| Principal Address: | 73 SOWAMS RD, BARRINGTON, RI, 02806, USA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134947997 | 2024-10-01 | 2024-10-01 | 47 WOOD AVE STE 2, BARRINGTON, RI, 028063503, US | 2109 HARTFORD AVE, JOHNSTON, RI, 029193246, US | |||||||||||||||
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| Phone | +1 626-319-5932 |
| Fax | 6263802395 |
Authorized person
| Name | DR. BRIAN MIKOLASKO |
| Role | PRESIDENT, CHIEF MEDICAL OFFICER |
| Phone | 6263195932 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| NORTHWEST REGISTERED AGENT LLC | Agent | 47 WOOD AVE SUITE 2, BARRINGTON, RI, 02806, USA |
| Number | Name | File Date |
|---|---|---|
| 202460382670 | Articles of Organization | 2024-09-30 |
Date of last update: 29 Oct 2024
Sources: Rhode Island Department of State
