1851486682 NPI number — CAPE COD MEDICAL ENTERPRISES INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851486682 NPI number — CAPE COD MEDICAL ENTERPRISES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAPE COD MEDICAL ENTERPRISES INC
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:
Provider Other Organization Name Type Code:
6
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:
1851486682
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 292
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YARMOUTH PORT
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02675
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-775-0494
Provider Business Mailing Address Fax Number:
508-790-0396

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
57 MID TECH DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST YARMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02673
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-775-0494
Provider Business Practice Location Address Fax Number:
508-790-0396
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GILDEA
Authorized Official First Name:
LEO
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
508-775-0494

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 085759 . This is a "BCBS BIRMINGHAM AL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 085759 . This is a "BCBS INDEPENDT PA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 085759 . This is a "BCBS CAMP HILL PA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 085759 . This is a "ANTHEM BCBS NORTH HAVEN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 085759 . This is a "BCBS DATA CAPTURE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 085759 . This is a "BCBS DETROIT MI POB 2500" identifier . This identifiers is of the category "OTHER".
  • Identifier: 700343 . This is a "HARVARD PILGRIM HEALTHCAR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 085759 . This is a "BCBS CHICAGO IL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1713108 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0084274 . This is a "AETNA BLUE BELL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 085759 . This is a "BCBS BUFFALO NY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 085759 . This is a "BCBS DALLAS TX" identifier . This identifiers is of the category "OTHER".
  • Identifier: 085759 . This is a "BCBS CHATANOOGA TN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 085759 . This is a "BCBS DURHAM NC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 085759 . This is a "BCBS CLEVELAND OH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 800793 . This is a "TUFTS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 085759 . This is a "BCBS ALBANY NY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 085759 . This is a "BCBS COLUMBUS GA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 085759 . This is a "BCBS DETROIT MI POB 166" identifier . This identifiers is of the category "OTHER".




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