Provider Demographics
NPI:1992897243
Name:CAPE COD MEDICAL ENTERPRISES INC
Entity type:Organization
Organization Name:CAPE COD MEDICAL ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-876-2100
Mailing Address - Street 1:PO BOX 842323
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-2323
Mailing Address - Country:US
Mailing Address - Phone:888-876-2100
Mailing Address - Fax:
Practice Address - Street 1:57 MID-TECH DR
Practice Address - Street 2:
Practice Address - City:WEST YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02673-2561
Practice Address - Country:US
Practice Address - Phone:508-775-0494
Practice Address - Fax:508-790-0396
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FALCK USA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-28
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3416L0300X
MA34753416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
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085859OtherBCBS COLUMBIA SC
085859OtherBCBS DALLAS TX
085859OtherANTHEM BCBS NORTH HAVEN
085859OtherBCBS BUFFALO NY
085859OtherBCBS DETROIT MI POB 2500
085859OtherBCBS DURHAM NC
085859OtherBCBS DATA CAPTURE
MA1713094Medicaid
700134OtherHARVARD PILGRIM HEALTH
800793OtherTUFTS HEALTH PLAN
085859OtherBCBS DETROIT MI POB 166
MA110031154Medicaid
085859OtherBCBS BIRMINGHAM AL
085859OtherBCBS CAMP HILL PA
085859OtherBCBS CHICAGO IL
MA110031154Medicaid