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ASSOCIATED NORTHWEST UROLOGY, P.C.

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Company Details

Entity Name: ASSOCIATED NORTHWEST UROLOGY, P.C.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Dissolved
Sub status: Annual report past due
Date Formed: 02 Sep 1980
Business ALEI: 0109070
Annual report due: 28 Sep 2021
Business address: 17 HOSPITAL HILL RD P.O. BOX 1736, SHARON, CT, 06069, United States
Mailing address: P.O. BOX 1736 17 HOSPITAL HILL RD, SHARON, CT, United States, 06069
ZIP code: 06069
County: Litchfield
Place of Formation: CONNECTICUT
Total authorized shares: 5000
E-Mail: JPIRC@ROSANNABELLCPA.COM

Industry & Business Activity

NAICS

621111 Offices of Physicians (except Mental Health Specialists)

Officer

Name Role Business address Residence address
JEROME K ROTH Officer 17 HOSPITAL HILL RD, PO BOX 1736, SHARON, CT, United States 115 SHARON GOSHEN RD, WEST CORNWALL, CT, United States

Agent

Name Role Business address E-Mail Residence address
PETER C SCHWARTZ Agent GORDON, MUIR & FOLEY, 39 LAFAYETTE ST, HARTFORD, CT, 06106, United States jkroth1@optonline.net 145 NATCHAUG DR, GLASTONBURY, CT, 06033, United States

National Provider Identifier

NPI Number:
1861539728

Authorized Person:

Name:
JEROME KARL ROTH
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208800000X - Urology Physician
Is Primary:
Yes

Contacts:

Fax:
8603641736

Form 5500 Series

Employer Identification Number (EIN):
061025643
Plan Year:
2024
Number Of Participants:
1
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
1
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
1
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
1
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
1
Sponsors Telephone Number:

History

Type Old value New value Date of change
Name change PHILIP B. JENSEN, M.D., F.A.C.S., P.C. ASSOCIATED NORTHWEST UROLOGY, P.C. 1984-06-04

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0010121705 2021-09-07 2021-09-07 Dissolution Certificate of Dissolution -
0007282304 2021-04-05 - Annual Report Annual Report 2020
0006615457 2019-08-06 - Annual Report Annual Report 2019
0006230843 2018-08-10 - Annual Report Annual Report 2018
0005941102 2017-10-04 - Annual Report Annual Report 2017

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Sources: Company Profile on Connecticut's Official State Website

* While we strive to keep this information correct and up-to-date, it is not the primary source, and the dataset source should always be referred to for definitive information