Healthcare Provider Details

I. General information

NPI: 1578726790
Provider Name (Legal Business Name): OUTER CAPE HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 STATE HWY
WELLFLEET MA
02667-7402
US

IV. Provider business mailing address

PO BOX 598
HARWICH PORT MA
02646-0598
US

V. Phone/Fax

Practice location:
  • Phone: 508-349-3131
  • Fax: 508-349-1311
Mailing address:
  • Phone: 508-905-2800
  • Fax: 508-240-1244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number4963
License Number StateMA

VIII. Authorized Official

Name: DAMIAN KELVIN LUTHER ARCHER
Title or Position: CEO
Credential: MD
Phone: 978-432-1400