Provider Demographics
NPI:1669650040
Name:WAYNE G. HJERPE
Entity Type:Organization
Organization Name:WAYNE G. HJERPE
Other - Org Name:EYE CARE CAPE COD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:G
Authorized Official - Last Name:HJERPE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:508-432-0020
Mailing Address - Street 1:PO BOX 752
Mailing Address - Street 2:
Mailing Address - City:WEST HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02671-0752
Mailing Address - Country:US
Mailing Address - Phone:508-432-0020
Mailing Address - Fax:508-432-7600
Practice Address - Street 1:120 ROUTE 28
Practice Address - Street 2:SUITE 200
Practice Address - City:WEST HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02671-1220
Practice Address - Country:US
Practice Address - Phone:508-432-0020
Practice Address - Fax:508-432-7600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAOP2916-TP332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0506480001Medicare NSC