Cape Cod Healthcare Inc

Organization Active NPI Community/Retail Pharmacy · Hyannis, MA

NPI 1457713232 · NPPES record last updated Feb 20, 2017

Key facts

NPI
1457713232
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
DS90036 (MA)
Legal business name
CAPE COD HEALTHCARE INC
Practice address
27 Park St
Hyannis, MA 02601-5230
Phone
(508) 862-5900
Fax
(508) 862-5877
NPI assigned
Mar 22, 2016
Organization subpart
No

Authorized official

Name
Angela Medeiros
Title
Pharmacy Operations Manager
Phone
(774) 392-3328

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 2

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

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MA

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cape Cod Hospital
Hyannis, MA · CCN 220012
Hospital 5% Or Greater Direct Ownership Interest (100%) May 23, 1984

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20170222000392 MA Part B Supplier - Mass Immunization (Roster Biller Only) 0648320887 3 other NPIs on this enrollment
Practice locations: Falmouth, MA; Hyannis, MA
O20190429002250 MA DME Supplier - Pharmacy 0648320887 Practice locations: Hyannis, MA

National Provider Directory

Tax ID family
Cape Cod Healthcare Inc (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X DS90036 MA Yes

Addresses

Primary practice location

27 Park St
Hyannis, MA 02601-5230

Mailing address

27 Park St
Hyannis, MA 02601-5230
Phone (508) 862-5900

Other identifiers

IdentifierTypeStateIssuer
2158926OtherPK
110108134CMedicaidMA

Other names

  • Cape Cod Healthcare Pharmacy at Cape Cod Hospital Doing business as

Other providers in Hyannis, MA

All providers in Hyannis, MA · Community/Retail Pharmacy in Massachusetts

Sources for this page

Verify at the official NPI Registry.