Healthcare Provider Details

I. General information

NPI: 1588616742
Provider Name (Legal Business Name): DUFFY HEALTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 MAIN ST
HYANNIS MA
02601-5205
US

IV. Provider business mailing address

94 MAIN ST
HYANNIS MA
02601-3146
US

V. Phone/Fax

Practice location:
  • Phone: 508-771-9599
  • Fax: 508-771-1986
Mailing address:
  • Phone: 508-771-9599
  • Fax: 508-771-1986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number410W
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE WROTEN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 508-771-7517