Provider Demographics
NPI:1376892570
Name:CAPE COD HEALTH NETWORK LLC
Entity Type:Organization
Organization Name:CAPE COD HEALTH NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:D
Authorized Official - Last Name:LIPOMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-862-5048
Mailing Address - Street 1:32 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3126
Mailing Address - Country:US
Mailing Address - Phone:508-862-5032
Mailing Address - Fax:
Practice Address - Street 1:32 MAIN ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3126
Practice Address - Country:US
Practice Address - Phone:508-862-5032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-04
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization