Provider Demographics
NPI:1366993388
Name:CAPE COD HOSPITAL
Entity type:Organization
Organization Name:CAPE COD HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, MEDICAL STAFF
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:GAGNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-862-5839
Mailing Address - Street 1:27 PARK ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-5230
Mailing Address - Country:US
Mailing Address - Phone:508-862-5114
Mailing Address - Fax:508-862-7316
Practice Address - Street 1:27 PARK ST
Practice Address - Street 2:MEDICAL STAFF OFFICE
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5230
Practice Address - Country:US
Practice Address - Phone:508-862-5114
Practice Address - Fax:508-862-7316
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPE COD HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA5821282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural