| East Bay Community Action Program | |
|
19 Broadway Newport RI 02840-2937 | |
| (401) 848-6697 | |
| (401) 847-6220 |
| Full Name | East Bay Community Action Program |
|---|---|
| Speciality | Clinic/Center |
| Location | 19 Broadway, Newport, Rhode Island |
| Authorized Official Name and Position | Rilwan Feyisitan (CEO) |
| Authorized Official Contact | 4018486697 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Bay Community Action Program 19 Broadway Newport RI 02840-2937 Ph: (401) 848-6697 | East Bay Community Action Program 19 Broadway Newport RI 02840-2937 Ph: (401) 848-6697 |
| NPI Number | 1861439705 |
|---|---|
| Provider Enumeration Date | 05/31/2006 |
| Last Update Date | 03/11/2025 |
| Medicare PECOS PAC ID | 1951298595 |
|---|---|
| Medicare Enrollment ID | O20040407001561 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861439705 | NPI | - | NPPES |
| EB51407 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 01520 (Rhode Island) | Secondary |
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