Healthcare Provider Details

I. General information

NPI: 1992897243
Provider Name (Legal Business Name): CAPE COD MEDICAL ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 03/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 MID-TECH DR
WEST YARMOUTH MA
02673-2561
US

IV. Provider business mailing address

PO BOX 842323
BOSTON MA
02284-2323
US

V. Phone/Fax

Practice location:
  • Phone: 508-775-0494
  • Fax: 508-790-0396
Mailing address:
  • Phone: 888-876-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number3475
License Number StateMA

VIII. Authorized Official

Name: CHARLES MAYMON
Title or Position: CEO
Credential:
Phone: 888-876-2100