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710 Main St Harwich Port MA 02646-1931 | |
(508) 432-1400 | |
(508) 487-6298 |
Full Name | |
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Speciality | Clinic/Center |
Location | 710 Main St, Harwich Port, Massachusetts |
Authorized Official Name and Position | Lina Lillian Winters (DIRECTOR OF REVENUE CYCLE) |
Authorized Official Contact | 5089052431 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 598 Harwich Port MA 02646-0598 Ph: (508) 905-2800 | 710 Main St Harwich Port MA 02646-1931 Ph: (508) 432-1400 |
NPI Number | 1255629747 |
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Provider Enumeration Date | 07/18/2011 |
Last Update Date | 09/15/2023 |
Medicare PECOS PAC ID | 4385554971 |
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Medicare Enrollment ID | O20120131000506 |
Identifier | Type | State | Issuer |
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1255629747 | NPI | - | NPPES |
110027866G | Medicaid | MA |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 4963 (Massachusetts) | Primary |