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  5. CONNECTICUT EMERGENCY MEDICINE SPECIALISTS, LLC

CONNECTICUT EMERGENCY MEDICINE SPECIALISTS, LLC

Company Details

Entity Name: CONNECTICUT EMERGENCY MEDICINE SPECIALISTS, LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Dissolved
Date Formed: 15 Nov 1996
Date of dissolution: 30 Nov 2022
Business ALEI: 0548056
NAICS code: 621111 - Offices of Physicians (except Mental Health Specialists)
Business address: 2909 BERLIN TPK, NEWINGTON, CT, 06111, United States
Mailing address: 2909 BERLIN TPK, NEWINGTON, CT, United States, 06111
ZIP code: 06111
County: Hartford
Place of Formation: CONNECTICUT
E-Mail: Lawrenceplevine@gmail.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CEMS RETIREMENT PLAN 2021 061468467 2022-10-14 CONNECTICUT EMERGENCY MEDICINE SPECIALISTS, LLC 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-03-10
Business code 621111
Sponsor’s telephone number 8604363757
Plan sponsor’s address 2909 BERLIN TURNPIKE, NEWINGTON, CT, 06111
CEMS RETIREMENT PLAN 2020 061468467 2021-10-13 CONNECTICUT EMERGENCY MEDICINE SPECIALISTS, LLC 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-03-10
Business code 621111
Sponsor’s telephone number 8604363757
Plan sponsor’s address 2909 BERLIN TURNPIKE, NEWINGTON, CT, 06111
CEMS RETIREMENT PLAN 2019 061468467 2020-10-14 CONNECTICUT EMERGENCY MEDICINE SPECIALISTS, LLC 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-03-10
Business code 621111
Sponsor’s telephone number 8604363757
Plan sponsor’s address 2909 BERLIN TURNPIKE, NEWINGTON, CT, 06111
CEMS RETIREMENT PLAN 2018 061468467 2019-10-01 CONNECTICUT EMERGENCY MEDICINE SPECIALISTS, LLC 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-03-10
Business code 621111
Sponsor’s telephone number 8604363757
Plan sponsor’s address 2909 BERLIN TURNPIKE, NEWINGTON, CT, 06111

Signature of
Role Plan administrator
Date 2019-10-01
Name of individual signing LAWRENCE P. LEVINE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-10-01
Name of individual signing LAWRENCE P. LEVINE
Valid signature Filed with authorized/valid electronic signature
CEMS RETIREMENT PLAN 2017 061468467 2018-07-30 CONNECTICUT EMERGENCY MEDICINE SPECIALISTS, LLC 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-03-10
Business code 621111
Sponsor’s telephone number 8604363757
Plan sponsor’s address 2909 BERLIN TURNPIKE, NEWINGTON, CT, 06111

Signature of
Role Plan administrator
Date 2018-07-30
Name of individual signing LAWRENCE P. LEVINE
Valid signature Filed with authorized/valid electronic signature
CEMS RETIREMENT PLAN 2016 061468467 2017-09-19 CONNECTICUT EMERGENCY MEDICINE SPECIALISTS, LLC 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-03-10
Business code 621111
Sponsor’s telephone number 8604363757
Plan sponsor’s address 2909 BERLIN TURNPIKE, NEWINGTON, CT, 06111

Signature of
Role Plan administrator
Date 2017-09-19
Name of individual signing LAWRENCE P. LEVINE
Valid signature Filed with authorized/valid electronic signature
CEMS RETIREMENT PLAN 2015 061468467 2016-04-25 CONNECTICUT EMERGENCY MEDICINE SPECIALISTS, LLC 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-03-10
Business code 621111
Sponsor’s telephone number 8604363757
Plan sponsor’s address 2909 BERLIN TURNPIKE, NEWINGTON, CT, 06111

Signature of
Role Plan administrator
Date 2016-03-29
Name of individual signing LAWRENCE P. LEVINE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-03-29
Name of individual signing LAWRENCE P. LEVINE
Valid signature Filed with authorized/valid electronic signature
CEMS RETIREMENT PLAN 2014 061468467 2015-07-31 CONNECTICUT EMERGENCY MEDICINE SPECIALISTS, LLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-03-10
Business code 621111
Sponsor’s telephone number 8604363757
Plan sponsor’s address 2909 BERLIN TURNPIKE, NEWINGTON, CT, 06111

Signature of
Role Plan administrator
Date 2015-07-31
Name of individual signing LAWRENCE P. LEVINE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-31
Name of individual signing LAWRENCE P. LEVINE
Valid signature Filed with authorized/valid electronic signature
CEMS RETIREMENT PLAN 2013 061468467 2014-08-12 CONNECTICUT EMERGENCY MEDICINE SPECIALISTS, LLC 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-03-01
Business code 621111
Sponsor’s telephone number 2036608660
Plan sponsor’s address 211 S MAIN ST, WEST HARTFORD, CT, 06107

Signature of
Role Plan administrator
Date 2014-08-12
Name of individual signing LAWRENCE P. LEVINE
Valid signature Filed with authorized/valid electronic signature
CEMS RETIREMENT PLAN 2012 061468467 2013-07-30 CONNECTICUT EMERGENCY MEDICINE SPECIALISTS, LLC 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-03-01
Business code 621111
Sponsor’s telephone number 2036608660
Plan sponsor’s address 211 S MAIN ST, WEST HARTFORD, CT, 06107

Signature of
Role Plan administrator
Date 2013-07-30
Name of individual signing LAWRENCE P. LEVINE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
HASLAW, INC. Agent

Officer

Name Role Business address Residence address
Cliff Wagner Officer 2909 BERLIN TPK, NEWINGTON, CT, 06111, United States 2909 BERLIN TPK, NEWINGTON, CT, 06111, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0011352402 2022-11-30 2022-11-30 Dissolution Certificate of Dissolution No data
BF-0010214942 2022-03-23 No data Annual Report Annual Report 2022
0007127650 2021-02-05 No data Annual Report Annual Report 2021
0006736607 2020-01-30 No data Annual Report Annual Report 2019
0006736608 2020-01-30 No data Annual Report Annual Report 2020
0006355152 2019-02-01 No data Annual Report Annual Report 2018
0005941806 2017-10-05 No data Annual Report Annual Report 2015
0005941813 2017-10-05 No data Annual Report Annual Report 2017
0005941809 2017-10-05 No data Annual Report Annual Report 2016
0005602972 2016-06-27 2016-06-27 Change of Business Address Business Address Change No data

Related by officers

No related officers

Related by address

2909 BERLIN TPK, NEWINGTON, CT, 06111, United States

PREMIER HEALTHCARE SERVICES OF CONNECTICUT, LLC

2909 BERLIN TPK, NEWINGTON, CT, United States, 06111

PREMIER HEALTHCARE SERVICES OF CONNECTICUT, LLC

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website

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