Provider Demographics
NPI:1154459618
Name:HEALTHQUARTERS, INC
Entity Type:Organization
Organization Name:HEALTHQUARTERS, INC
Other - Org Name:HEALTH QUARTERS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-522-5610
Mailing Address - Street 1:PO BOX 7050
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-0090
Mailing Address - Country:US
Mailing Address - Phone:978-522-5610
Mailing Address - Fax:978-922-5904
Practice Address - Street 1:100 CUMMINGS CTR STE 110E
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6105
Practice Address - Country:US
Practice Address - Phone:978-927-9824
Practice Address - Fax:978-998-4195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning FacilityGroup - Single Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110029587AMedicaid