Provider Demographics
NPI:1952415036
Name:CITY OF QUINCY
Entity Type:Organization
Organization Name:CITY OF QUINCY
Other - Org Name:QUINCY HEALTH DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:COMMISSIONER OF PUBLIC HEALTH
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHEELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-376-1272
Mailing Address - Street 1:440 EAST SQUANTUM ST.
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171
Mailing Address - Country:US
Mailing Address - Phone:617-376-1285
Mailing Address - Fax:617-376-1271
Practice Address - Street 1:440 EAST SQUANTUM ST.
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171
Practice Address - Country:US
Practice Address - Phone:617-376-1285
Practice Address - Fax:617-376-1271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY11083Medicare PIN