Provider Demographics
NPI:1700669140
Name:COMPLETE 1 HEALTHCARE
Entity Type:Organization
Organization Name:COMPLETE 1 HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DRPH, FNP
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUARLES-JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:DRPH, FNP, MPH
Authorized Official - Phone:781-660-9330
Mailing Address - Street 1:529 MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-1119
Mailing Address - Country:US
Mailing Address - Phone:781-660-9330
Mailing Address - Fax:
Practice Address - Street 1:529 MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129-1119
Practice Address - Country:US
Practice Address - Phone:781-660-9330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-18
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service