Provider Demographics
NPI:1417903345
Name:LOWER CAPE AMBULANCE ASSOCIATION, INC
Entity Type:Organization
Organization Name:LOWER CAPE AMBULANCE ASSOCIATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:RODERICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-487-1733
Mailing Address - Street 1:PO BOX 161
Mailing Address - Street 2:
Mailing Address - City:WHITINSVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01588-0161
Mailing Address - Country:US
Mailing Address - Phone:508-476-9740
Mailing Address - Fax:508-476-9748
Practice Address - Street 1:24 RACE POINT RD
Practice Address - Street 2:
Practice Address - City:PROVINCETOWN
Practice Address - State:MA
Practice Address - Zip Code:02657-1528
Practice Address - Country:US
Practice Address - Phone:508-487-1733
Practice Address - Fax:508-487-2287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA096759OtherBCBS PROVIDER NUMBER
MA1714864Medicaid
MA012259Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER