Healthcare Provider Details

I. General information

NPI: 1124788500
Provider Name (Legal Business Name): COMMUNITY HEALTH CENTER OF CAPE COD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2021
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 JONES RD
FALMOUTH MA
02540-4900
US

IV. Provider business mailing address

107 COMMERCIAL ST
MASHPEE MA
02649-6507
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KAREN L GARDNER
Title or Position: CEO
Credential:
Phone: 508-539-6000