Healthcare Provider Details

I. General information

NPI: 1144743410
Provider Name (Legal Business Name): COMMUNITY HEALTH CENTER OF CAPE COD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2017
Last Update Date: 07/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 WATERHOUSE RD
BOURNE MA
02532-3890
US

IV. Provider business mailing address

107 COMMERCIAL ST
MASHPEE MA
02649-6507
US

V. Phone/Fax

Practice location:
  • Phone: 508-539-6000
  • Fax: 508-477-7028
Mailing address:
  • Phone: 508-477-7090
  • Fax: 508-477-7028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number StateMA

VIII. Authorized Official

Name: KAREN GARDNER
Title or Position: CEO
Credential:
Phone: 508-477-7090