Healthcare Provider Details

I. General information

NPI: 1154459618
Provider Name (Legal Business Name): HEALTHQUARTERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 08/04/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CUMMINGS CTR STE 110E
BEVERLY MA
01915-6105
US

IV. Provider business mailing address

PO BOX 7050
BEVERLY MA
01915-0090
US

V. Phone/Fax

Practice location:
  • Phone: 978-927-9824
  • Fax: 978-998-4195
Mailing address:
  • Phone: 978-522-5610
  • Fax: 978-922-5904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State

VIII. Authorized Official

Name: GABRIELLE CATHERINE ROSS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 978-522-5610