Healthcare Provider Details

I. General information

NPI: 1851486682
Provider Name (Legal Business Name): CAPE COD MEDICAL ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 04/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 MID TECH DR
WEST YARMOUTH MA
02673
US

IV. Provider business mailing address

PO BOX 292
YARMOUTH PORT MA
02675
US

V. Phone/Fax

Practice location:
  • Phone: 508-775-0494
  • Fax: 508-790-0396
Mailing address:
  • Phone: 508-775-0494
  • Fax: 508-790-0396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. LEO F GILDEA
Title or Position: PRESIDENT
Credential:
Phone: 508-775-0494