1932208352 NPI number — CAPE COD USCG PHCY

Table of content: (NPI 1932208352)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932208352 NPI number — CAPE COD USCG PHCY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAPE COD USCG PHCY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CAPE COD USCG PHCY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932208352
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/08/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
US COAST GUARD FINANCE CTR
Provider Second Line Business Mailing Address:
1430 KRISTINA WAY
Provider Business Mailing Address City Name:
CHESAPEAKE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23326-0002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-536-6650
Provider Business Mailing Address Fax Number:
210-536-6179

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
KAEHLER MEMORIAL MEDICAL CLINIC
Provider Second Line Business Practice Location Address:
5201 LEE RD US AIR STATION
Provider Business Practice Location Address City Name:
CAPE COD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-968-6702
Provider Business Practice Location Address Fax Number:
508-968-6620
Provider Enumeration Date:
09/22/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MORALES
Authorized Official First Name:
HECTOR
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF DHA PASS
Authorized Official Telephone Number:
210-536-6650

Provider Taxonomy Codes

  • Taxonomy code: 332000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2039156 . This is a "PK" identifier . This identifiers is of the category "OTHER".