Provider Demographics
NPI:1720313315
Name:COMMUNITY HEALTH CENTER OF CAPE COD, INC.
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CENTER OF CAPE COD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-539-6000
Mailing Address - Street 1:107 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-6507
Mailing Address - Country:US
Mailing Address - Phone:508-477-7090
Mailing Address - Fax:508-477-7028
Practice Address - Street 1:744 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3487
Practice Address - Country:US
Practice Address - Phone:508-477-7090
Practice Address - Fax:508-477-7028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4WAE261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health