Provider Demographics
NPI:1619308467
Name:BARNSTABLE COUNTY
Entity Type:Organization
Organization Name:BARNSTABLE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEUFELDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-375-6616
Mailing Address - Street 1:3195 MAIN ST
Mailing Address - Street 2:OLD JAIL BUILDING
Mailing Address - City:BARNSTABLE
Mailing Address - State:MA
Mailing Address - Zip Code:02630-1105
Mailing Address - Country:US
Mailing Address - Phone:508-375-6614
Mailing Address - Fax:
Practice Address - Street 1:3195 MAIN ST
Practice Address - Street 2:OLD JAIL BUILDING
Practice Address - City:BARNSTABLE
Practice Address - State:MA
Practice Address - Zip Code:02630-1105
Practice Address - Country:US
Practice Address - Phone:508-375-6614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-04
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN225946251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110027390DMedicaid