Healthcare Provider Details

I. General information

NPI: 1700669140
Provider Name (Legal Business Name): COMPLETE 1 HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2023
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 MAIN ST STE 200
CHARLESTOWN MA
02129-1119
US

IV. Provider business mailing address

529 MAIN ST STE 200
CHARLESTOWN MA
02129-1119
US

V. Phone/Fax

Practice location:
  • Phone: 781-660-9330
  • Fax:
Mailing address:
  • Phone: 781-660-9330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JACQUELYN QUARLES-JOSEPH
Title or Position: DRPH, FNP
Credential: DRPH, FNP, MPH
Phone: 781-660-9330