Medicaid Billing | NPI: Number | Insert | Change Request | | 1245389576 | 4/21/2025 1:33 PM |
Medicaid Billing | NPI: State | Insert | Change Request | | RI | 4/21/2025 1:33 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1427833243 | 3/3/2025 4:28 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 3/3/2025 4:28 PM |
Details | Last Recertification Date | Update | Recertification | 2/7/2024 12:50:42 PM | 3/3/2025 4:28:29 PM | 3/3/2025 4:28 PM |
Medicaid Billing | NPI: Number | Delete | Change Request | 1063628717 (RI) | | 10/15/2024 9:47 AM |
Medicaid Billing | NPI: Number | Delete | Change Request | 1245389576 (RI) | | 10/15/2024 9:47 AM |
Medicaid Billing | NPI: Number | Delete | Change Request | 1396425427 (RI) | | 10/15/2024 9:47 AM |
Contacts | Primary Contact | Update | Profile Change Request | Redmond, Gwen
Manager of Strategic Initiatives
EBCAP
4014081085 | Redmond, Gwen
Director of Strategic Initiatives
EBCAP
4014081085 | 10/8/2024 9:40 AM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1235517913 (RI) | | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1174931216 (RI) | | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1356723548 (RI) | | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1215085816 (RI) | | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1447488259 (RI) | | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1639716384 (RI) | | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1467501882 (RI) | | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1306995675 (RI) | | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1013060391 (RI) | | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1780051664 (RI) | | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1013034016 | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1104279546 | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1336768027 | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1386328631 | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1396425427 | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1396493243 | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1396925186 | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1407259260 | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1720066145 | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1790493732 | 2/7/2024 12:50 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/7/2024 12:50 PM |
Details | Last Recertification Date | Update | Recertification | 2/23/2023 10:25:51 AM | 2/7/2024 12:50:42 PM | 2/7/2024 12:50 PM |
Contacts | Authorizing Official | Update | Change Request | Roy, Dennis
CEO
EBCAP
4014371000-126 | Feyisitan, Rilwan
President/CEO
East Bay Community Action Program
4014371000-1132 | 7/13/2023 5:47 PM |
Contacts | Primary Contact | Update | Profile Change Request | Redmond, Gwen
Administrative Assistant
EBCAP
4014081085 | Redmond, Gwen
Manager of Strategic Initiatives
EBCAP
4014081085 | 2/27/2023 11:44 AM |
Details | Last Recertification Date | Update | Recertification | 2/25/2022 1:27:50 PM | 2/23/2023 10:25:51 AM | 2/23/2023 10:25 AM |
Details | Last Recertification Date | Update | Recertification | 2/17/2021 3:54:34 PM | 2/25/2022 1:27:50 PM | 2/25/2022 1:27 PM |
Contacts | Primary Contact | Update | Change Request | MIller, Virginia
Administrative Assistant
EBCAP
4014371008-165 | Redmond, Gwen
Administrative Assistant
EBCAP
4014081085 | 2/18/2021 5:01 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609925122 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609239920 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1487916136 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1861439705 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1689732497 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1235517913 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1598306383 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1063628717 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1174931216 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1356723548 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1043455694 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1972651529 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1841355567 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1215085816 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1245389576 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1447488259 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1639716384 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1528394525 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1003249178 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1467501882 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1649801564 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1306995675 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1013060391 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1780051664 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1396728200 | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | RI | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1609925122 ( ) | | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1609239920 ( ) | | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1861439705 ( ) | | 2/17/2021 3:54 PM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1487916136 ( ) | | 2/17/2021 3:54 PM |
Details | Last Recertification Date | Update | Recertification | 2/4/2020 1:33:24 PM | 2/17/2021 3:54:34 PM | 2/17/2021 3:54 PM |
Details | Last Recertification Date | Update | Recertification | 1/30/2019 3:53:59 PM | 2/4/2020 1:33:24 PM | 2/4/2020 1:33 PM |
Addresses | Billing Address | Insert | Recertification | | East Bay Community Action Program
19 Braodway
Newport, RI 02840 | 1/30/2019 3:53 PM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1609239920 ( ) | | 1/30/2019 3:53 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609925122 | 1/30/2019 3:53 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609239920 | 1/30/2019 3:53 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1861439705 | 1/30/2019 3:53 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1487916136 | 1/30/2019 3:53 PM |
Details | Last Recertification Date | Update | Recertification | 2/8/2018 11:41:58 AM | 1/30/2019 3:53:59 PM | 1/30/2019 3:53 PM |
Medicaid Billing | Medicaid: Is Primary | Insert | Change Request | | False | 10/25/2018 10:47 AM |
Medicaid Billing | Medicaid: Number | Insert | Change Request | | EB51407 | 10/25/2018 10:47 AM |
Medicaid Billing | Medicaid: State | Insert | Change Request | | RI | 10/25/2018 10:47 AM |
Medicaid Billing | NPI: Number | Insert | Change Request | | 1609239920 | 10/25/2018 10:47 AM |
Contacts | Primary Contact | Update | Change Request | Ozanian, Bobbi
Administrative Assistant
EBCAP
4014371008-165 | MIller, Virginia
Administrative Assistant
EBCAP
4014371008-165 | 10/24/2018 11:56 AM |
Addresses | Main Address | Update | Change Request |
2 Country Road
Barrington, RI 02806 |
2 Old Country Road
Barrington, RI 02806 | 10/3/2018 4:04 PM |
Details | Is Authorizing Official EHB Data | Update | Change Request | False | | 10/3/2018 4:04 PM |
Details | Last Recertification Date | Update | Recertification | 1/25/2017 12:00:00 AM | 2/8/2018 11:41:58 AM | 2/8/2018 11:41 AM |
Contacts | Authorizing Official | Update | | Roy, Dennis
CEO
4014371000-126 | Roy, Dennis
CEO
EBCAP
4014371000-126 | 10/13/2017 1:57 PM |
Contacts | Signed By | Update | | Roy, Dennis
CEO
4014371000-126 | Roy, Dennis
CEO
EBCAP
4014371000-126 | 10/13/2017 1:57 PM |
Contacts | Primary Contact | Update | | Ozanian, Bobbi
Administrative Assistant
4014371008-165 | Ozanian, Bobbi
Administrative Assistant
EBCAP
4014371008-165 | 10/13/2017 11:47 AM |
Addresses | Main Address | Insert | | |
2 Country Road
Barrington, RI 02806 | 1/25/2017 9:04 AM |
Contacts | Primary Contact | Insert | | | Ozanian, Bobbi
Administrative Assistant
4014371008-165 | 1/25/2017 9:04 AM |
Contacts | Authorizing Official | Insert | | | Roy, Dennis
CEO
4014371000-126 | 1/25/2017 9:04 AM |
Contacts | Signed By | Insert | | | Roy, Dennis
CEO
4014371000-126 | 1/25/2017 9:04 AM |
Details | Last Recertification Date | Update | | | 1/25/2017 12:00:00 AM | 1/25/2017 9:04 AM |
Dates | Participating Approval Date | Update | | | 2/10/2016 12:00:00 AM | 2/10/2016 5:11 PM |
Details | State | Update | | Pending | Active | 2/10/2016 5:11 PM |
Dates | Start Date | Update | | | 4/1/2016 12:00:00 AM | 2/10/2016 5:11 PM |
Details | 340B ID | Update | | ONLINE_REG_58239 | CH01516E | 1/20/2016 7:50 AM |
Details | 340B ID | Update | | ONLINE_REG | ONLINE_REG_58239 | 1/15/2016 11:59 AM |
Details | Last Recertification Date | Insert | | | | 1/15/2016 11:59 AM |
Details | Grant Number | Insert | | | H80CS02329 | 1/15/2016 11:59 AM |
Details | 340B ID | Insert | | | ONLINE_REG | 1/15/2016 11:59 AM |
Details | Is Authorizing Official EHB Data | Insert | | | False | 1/15/2016 11:59 AM |
Dates | Last Date That 340B Drugs Purchased | Insert | | | | 1/15/2016 11:59 AM |
Details | Medicare Provider Number | Insert | | | | 1/15/2016 11:59 AM |
Details | Entity Name | Insert | | | EAST BAY COMMUNITY ACTION PROGRAM | 1/15/2016 11:59 AM |
Details | Program Code | Insert | | | CH | 1/15/2016 11:59 AM |
Details | Entity Subname | Insert | | | 2 Old County Road | 1/15/2016 11:59 AM |
Dates | Participating Approval Date | Insert | | | | 1/15/2016 11:59 AM |
Details | State | Insert | | | Pending | 1/15/2016 11:59 AM |
Dates | Registration Date | Insert | | | 1/15/2016 12:00:00 AM | 1/15/2016 11:59 AM |
Dates | Signed By Date | Insert | | | 1/15/2016 12:00:00 AM | 1/15/2016 11:59 AM |
Dates | Start Date | Insert | | | | 1/15/2016 11:59 AM |
Terminations | Termination Comments | Insert | | | | 1/15/2016 11:59 AM |
Terminations | Termination Date | Insert | | | | 1/15/2016 11:59 AM |
Terminations | Termination Effective Date | Insert | | | | 1/15/2016 11:59 AM |
Terminations | Termination Reason | Insert | | | | 1/15/2016 11:59 AM |