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Community Health Center of Cape Cod Inc

Organization Active NPI Clinic Pharmacy · Mashpee, MA

NPI 1124376413 · NPPES record last updated Feb 20, 2017

Key facts

NPI
1124376413
Entity type
Organization (NPI type 2)
Primary specialty
Clinic Pharmacy 3336C0002X
License
MA0061072 (MA)
Legal business name
COMMUNITY HEALTH CENTER OF CAPE COD INC
Practice address
107 Commercial St
Mashpee, MA 02649-6507
Phone
(508) 477-0004
Fax
(508) 477-0968
NPI assigned
Aug 17, 2012
Organization subpart
No

Authorized official

Name
Karen Gardner, BS
Title
Ceo
Phone
(508) 539-6000

Corporate family (same tax ID) 10

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Community Health Center of Cape Cod Inc (11 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X MA0061072 MA Yes

Addresses

Primary practice location

107 Commercial St
Mashpee, MA 02649-6507

Mailing address

107 Commercial St
Mashpee, MA 02649-6507
Phone (508) 477-0004

Other identifiers

IdentifierTypeStateIssuer
110027778DMedicaidMA
2136341OtherPK

Other names

  • Community Health Center of Cape Cod Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 20, 2017.

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1124376413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 COMMERCIAL ST",
            "city": "MASHPEE",
            "state": "MA",
            "postal_code": "026496507",
            "telephone_number": "508-477-0004",
            "fax_number": "508-477-0968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 COMMERCIAL ST",
            "city": "MASHPEE",
            "state": "MA",
            "postal_code": "026496507",
            "telephone_number": "508-477-0004",
            "fax_number": "508-477-0968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTER OF CAPE COD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-17",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "508-539-6000",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "MA",
            "license": "MA0061072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110027778D",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2136341",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Center of Cape Cod",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mashpee, MA

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Sources for this page

Verify at the official NPI Registry.