Provider Demographics
NPI:1548555147
Name:CAPE MEDICAL SUPPLY, INC.
Entity type:Organization
Organization Name:CAPE MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-888-3113
Mailing Address - Street 1:28 JAN SEBASTIAN DR
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-2361
Mailing Address - Country:US
Mailing Address - Phone:508-888-3111
Mailing Address - Fax:508-888-9266
Practice Address - Street 1:1 ROUTE 236
Practice Address - Street 2:
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904-5636
Practice Address - Country:US
Practice Address - Phone:800-894-2566
Practice Address - Fax:207-439-4793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-13
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA0081389332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1519344Medicaid
MA1519344Medicaid