| Entity Name: | EASTERN CONNECTICUT INDIVIDUAL PROVIDER GROUP, INC. |
| Jurisdiction: | Connecticut |
| Legal type: | Non-Stock |
| Citizenship: | Domestic |
| Status: | Forfeited |
| Date Formed: | 20 May 2005 |
| Business ALEI: | 0821987 |
| Business address: | 26 HAYNES STREET LOWER LEVEL, MANCHESTER, CT, 06040 |
| ZIP code: | 06040 |
| County: | Hartford |
| Place of Formation: | CONNECTICUT |
| E-Mail: | barbi@whitesite.com |
| Name | Role |
|---|---|
| R&C SERVICE COMPANY | Agent |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| BARBARA L. PHILLIPS MD | Officer | FAMILY MEDICINE CENTER, LLC, 574 EAST MIDDLE TPKE, MANCHESTER, CT, 06040, United States | 61 BRIGHAM TAVERN ROAD, COVENTRY, CT, 06238, United States |
| MARTIN J. HANCOCK | Officer | OBGYN GROUP OF EASTERN CONNECTICUT, P.C., ECHN MEDICAL OFFICE BUILDING AT EVERGREE, 2600 TAMARACK DRIVE, SUITE 200, SOUTH WINDSOR, CT, 06074, United States | 16 SUNRISE LANE, SOUTH WINDSOR, CT, 06074, United States |
| KAREN CADMAN MD | Officer | HEALTHWISE MEDICAL ASSOCIATES, LLP, 375 EAST CENTER STREET, MANCHESTER, CT, 06040, United States | 96 BIRCH HILL DRIVE, SOUTH WINDSOR, CT, 06074, United States |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0012732941 | 2024-08-14 | No data | Mass Agent Change � Address | Agent Address Change | No data |
| BF-0011953198 | 2023-08-31 | No data | Administrative Dissolution | Certificate of Dissolution/Revocation | No data |
| BF-0011826252 | 2023-05-30 | No data | Administrative Dissolution | Notice of Intent to Dissolve/Revoke | No data |
| 0006180724 | 2018-05-09 | No data | Annual Report | Annual Report | 2018 |
| 0006180719 | 2018-05-09 | No data | Annual Report | Annual Report | 2017 |
| 0005634169 | 2016-08-22 | No data | Annual Report | Annual Report | 2016 |
| 0005370740 | 2015-07-24 | No data | Annual Report | Annual Report | 2015 |
| 0005163507 | 2014-08-13 | No data | Annual Report | Annual Report | 2014 |
| 0004857465 | 2013-05-10 | No data | Annual Report | Annual Report | 2013 |
| 0004602767 | 2012-04-30 | No data | Annual Report | Annual Report | 2012 |
Date of last update: 06 Jan 2025
Sources: Connecticut's Official State Website
