Provider Demographics
NPI:1760577597
Name:CAPE COD MEDICAL ENTERPRISES INC
Entity Type:Organization
Organization Name:CAPE COD MEDICAL ENTERPRISES INC
Other - Org Name:CAPE COD WHEELCHAIR TRANSIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LEO
Authorized Official - Middle Name:F
Authorized Official - Last Name:GILDEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-775-0494
Mailing Address - Street 1:PO BOX 328
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02675
Mailing Address - Country:US
Mailing Address - Phone:508-775-0494
Mailing Address - Fax:508-790-0396
Practice Address - Street 1:57 MID TECH DR
Practice Address - Street 2:
Practice Address - City:WEST YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02673
Practice Address - Country:US
Practice Address - Phone:508-775-0494
Practice Address - Fax:508-790-0396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
085859OtherBCBS MA
MA1713132Medicaid
804347OtherTUFTS MEDICARE PREFERRED
804347OtherTUFTS HEALTH PLAN
0038672OtherNEIGHBORHOOD HEALTH PLAN
1713132OtherMASSHEALTH
700867OtherHARVARD PILGRIM HEALTHCAR
000000025432OtherBMC HEALTH NET PLAN