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General NPI Number Information
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NPI Number | 1124376413
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH CENTER OF CAPE COD INC
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Dates
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Enumeration Date | 08/17/2012
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 107 COMMERCIAL ST
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City | MASHPEE
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State | MA
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Zip | 02649-6507
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Country | US
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Telephone | 508-477-0004
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Fax | 508-477-0968
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Provider Business Mailing Address
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Address Line | 107 COMMERCIAL ST
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City | MASHPEE
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State | MA
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Zip | 02649-6507
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Country | US
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Telephone | 508-477-0004
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Fax | 508-477-0968
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Authorized Official
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Title or Position | CEO
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Name | KAREN GARDNER
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Credential | BS
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Telephone | 508-539-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | MA0061072
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License Number State | MA
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