Covered Entity Details

STD019151 Health Quarters d/b/a HealthQ (Active) - information as of 5/29/2025 1:57:52 AM

Main Details

Name

Health Quarters d/b/a HealthQ

Subdivision Name

Beverly Site

Type

Sexually Transmitted Diseases

340B ID

STD019151

Grant Number

6 NH25PS005167-05-06

Nature of Support
Please Describe the “in-kind” Support
Time period section 318 funding or in-kind support was received

In-Kind products or services (see note below; must have been purchased with section 318 funds)
Note: In-kind contributions may be in the form of real property, equipment, supplies and other expendable property, and goods and services directly benefiting and specifically identifiable to the project or program.
1) Condoms provided by Massachusetts DPH, DSTDP, 2) Benzathine Penicillin G delivery provided by Massachusetts DPH, DSTDP for patients who would otherwise be at risk of not receiving treatment for syphilis, and 3) Specimens for STI testing are sent to and processed/resulted by the Massachusetts State Public Health Laboratory through a program funded using the 19-1901 award.
1/1/2019

Additional Details

Current Program Status

Active

Registration Date

1/12/2017

Participating Start Date

4/1/2017

Participating Approval Date

3/15/2017

Last Recertification Date

6/1/2024

Notice of Funding Opportunity (NOFO) Number

PS19-1901

Contacts

Authorizing Official

Health Quarters, Inc.
Kristie Monast, Executive Director
(978) 927-9824 Ext: 2110

Primary Contact

Health Quarters
Rachel Zamora, Director of Administrative Operations
(978) 927-9824 Ext: 2100

Addresses

Street Address

100 Cummings Center
Suite 110-E
Beverly, MA 01915

Billing Address

Health Quarters
PO Box 7050
Beverly, MA 01915

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
MA	110029587A	1154459618

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Last Updated On
Contract Detail	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	12/18/2020	12/30/2020	12/30/2020
Contract Detail	AVITA PHARMACY 1061	PHARMBLUE MASSACHUSETTS LLC DBA AVITA PH	163 PLEASANT ST	ATTLEBORO	MA	02703-2457	12/18/2020	12/30/2020	12/30/2020
Contract Detail	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	12/18/2020	12/30/2020	12/30/2020
Contract Detail	PHARMBLUE LLC DBA AVITA PHARMACY 1059	1226 CHESTNUT ST		PHILADELPHIA	PA	19107	12/18/2020	12/30/2020	12/30/2020

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Nature of Support: In Kind Support Description	Update	Recertification	1) Condoms provided by Massachusetts DPH, DSTDP, 2) Benzathine Penicillin G delivery provided by Massachusetts DPH, DSTDP for patients who would otherwise be at risk of not receiving treatment for syphilis, 3)Specimens for STI testing are sent to and processed/resulted by the Massachusetts State Public Health Laboratory through a program funded using the 19-1901 award.	1) Condoms provided by Massachusetts DPH, DSTDP, 2) Benzathine Penicillin G delivery provided by Massachusetts DPH, DSTDP for patients who would otherwise be at risk of not receiving treatment for syphilis, and 3) Specimens for STI testing are sent to and processed/resulted by the Massachusetts State Public Health Laboratory through a program funded using the 19-1901 award.	6/1/2024 6:46 AM
Details	Last Recertification Date	Update	Recertification	5/23/2023 8:11:56 AM	6/1/2024 6:46:24 AM	6/1/2024 6:46 AM
Details	Grant Number	Update	Recertification	NH25PS005167-05-02	6 NH25PS005167-05-06	6/1/2024 6:46 AM
Details	Nature of Support: In Kind Support Description	Update	Recertification	STI laboratory testing services and treatment.	1) Condoms provided by Massachusetts DPH, DSTDP, 2) Benzathine Penicillin G delivery provided by Massachusetts DPH, DSTDP for patients who would otherwise be at risk of not receiving treatment for syphilis, 3)Specimens for STI testing are sent to and processed/resulted by the Massachusetts State Public Health Laboratory through a program funded using the 19-1901 award.	5/23/2023 8:11 AM
Details	Last Recertification Date	Update	Recertification	5/19/2022 10:54:23 AM	5/23/2023 8:11:56 AM	5/23/2023 8:11 AM
Details	Grant Number	Update	Recertification	5 NH25PS005167-03-03	NH25PS005167-05-02	5/23/2023 8:11 AM
Details	Entity Name	Update	Recertification	Health Quarters	Health Quarters d/b/a HealthQ	5/23/2023 8:11 AM
Details	Nature of Support: In Kind Support Description	Update	Recertification	STI laboratory testing services.	STI laboratory testing services and treatment.	5/19/2022 10:54 AM
Details	Last Recertification Date	Update	Recertification	5/20/2021 7:59:20 AM	5/19/2022 10:54:23 AM	5/19/2022 10:54 AM
Details	Grant Number	Update	Recertification	5 NH25PS004332-05-00	5 NH25PS005167-03-03	5/19/2022 10:54 AM
Contacts	Authorizing Official	Update	Group Change Request	Ross, Gabrielle Executive Director Health Quarters 9784894993	Monast, Kristie Executive Director Health Quarters, Inc. 9789279824-2110	3/29/2022 12:37 PM
Details	Nature of Support: In Kind Support Description	Update	Recertification		STI laboratory testing services.	5/20/2021 7:59 AM
Details	Nature of Support: Support Received From Date	Update	Recertification		1/1/2019 12:00:00 AM	5/20/2021 7:59 AM
Medicaid Billing	NPI: State	Update	Recertification		MA	5/20/2021 7:59 AM
Details	Last Recertification Date	Update	Recertification	6/9/2020 12:17:47 PM	5/20/2021 7:59:20 AM	5/20/2021 7:59 AM
Details	NOFO Number	Update	Recertification		PS19-1901	5/20/2021 7:59 AM
Contacts	Authorizing Official	Update	Profile Change Request	Ross, Gabrielle Executive Director Health Quarters 9785225610	Ross, Gabrielle Executive Director Health Quarters 9784894993	5/19/2021 2:20 PM
Contacts	Signed By	Update	Profile Change Request	Ross, Gabrielle Executive Director Health Quarters 9785225610	Ross, Gabrielle Executive Director Health Quarters 9784894993	5/19/2021 2:20 PM
Contacts	Primary Contact	Update	Profile Change Request	Zamora, Rachel Administrative Coordinator Health Quarters 9785225600	Zamora, Rachel Director of Administrative Operations Health Quarters 9789279824-2100	5/17/2021 11:45 AM
Details	Last Recertification Date	Update	Recertification	6/6/2019 7:19:10 AM	6/9/2020 12:17:47 PM	6/9/2020 12:17 PM
Addresses	Main Address	Update	Change Request	100 Cummings Center Suite 131-Q Beverly, MA 01915	100 Cummings Center Suite 110-E Beverly, MA 01915	12/16/2019 8:26 AM
Details	Last Recertification Date	Update	Recertification	5/5/2018 12:56:41 PM	6/6/2019 7:19:10 AM	6/6/2019 7:19 AM
Details	Grant Number	Update	Recertification	NH25PS004332	5 NH25PS004332-05-00	6/6/2019 7:19 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	5/5/2018 12:56 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		110029587A	5/5/2018 12:56 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		MA	5/5/2018 12:56 PM
Details	Last Recertification Date	Update	Recertification	4/27/2017 12:00:00 AM	5/5/2018 12:56:41 PM	5/5/2018 12:56 PM
Details	Grant Number	Update	Recertification	6 NH25PS004332-03-01	NH25PS004332	5/5/2018 12:56 PM
Details	Entity Subname	Update	Recertification	Beverly Health Center	Beverly Site	5/5/2018 12:56 PM
Contacts	Authorizing Official	Update		Ross, Gabrielle Executive Director 9785225610	Ross, Gabrielle Executive Director Health Quarters 9785225610	4/25/2018 12:01 PM
Contacts	Signed By	Update		Ross, Gabrielle Executive Director 9785225610	Ross, Gabrielle Executive Director Health Quarters 9785225610	4/25/2018 12:01 PM
Contacts	Primary Contact	Update	Profile Change Request	Zamora, Rachel Administrative Assistant Health Quarters 9785225600	Zamora, Rachel Administrative Coordinator Health Quarters 9785225600	4/24/2018 11:06 PM
Contacts	Primary Contact	Update		Zamora, Rachel Administrative Assistant 9785225600	Zamora, Rachel Administrative Assistant Health Quarters 9785225600	10/12/2017 11:13 AM
Contacts	Authorizing Official	Insert			Ross, Gabrielle Executive Director 9785225610	5/16/2017 10:49 AM
Contacts	Signed By	Insert			Ross, Gabrielle Executive Director 9785225610	5/16/2017 10:49 AM
Contacts	Primary Contact	Insert			Zamora, Rachel Administrative Assistant 9785225600	5/16/2017 10:49 AM
Addresses	Main Address	Insert			100 Cummings Center Suite 131-Q Beverly, MA 01915	4/27/2017 10:25 AM
Addresses	Billing Address	Insert			Health Quarters PO Box 7050 Beverly, MA 01915	4/27/2017 10:25 AM
Details	Last Recertification Date	Update			4/27/2017 12:00:00 AM	4/27/2017 10:24 AM
Dates	Participating Approval Date	Update			3/15/2017 12:00:00 AM	3/15/2017 10:59 AM
Details	State	Update		Pending	Active	3/15/2017 10:59 AM
Dates	Start Date	Update			4/1/2017 12:00:00 AM	3/15/2017 10:59 AM
Details	340B ID	Update		ONLINE_REG_74705	STD019151	1/24/2017 11:32 AM
Details	Grant Number	Update		STD-MA	6 NH25PS004332-03-01	1/24/2017 11:11 AM
Details	Nature Of Support	Insert			In-Kind products or services (see note below; must have been purchased with section 318 funds)	1/12/2017 3:14 PM
Details	340B ID	Update		ONLINE_REG	ONLINE_REG_74705	1/12/2017 3:14 PM
Medicaid Billing	NPI: Number	Insert			1154459618	1/12/2017 3:13 PM
Details	Last Recertification Date	Insert				1/12/2017 3:13 PM
Details	Grant Number	Insert			STD-MA	1/12/2017 3:13 PM
Details	340B ID	Insert			ONLINE_REG	1/12/2017 3:13 PM
Details	Is Authorizing Official EHB Data	Insert				1/12/2017 3:13 PM
Dates	Last Date That 340B Drugs Purchased	Insert				1/12/2017 3:13 PM
Details	Medicare Provider Number	Insert				1/12/2017 3:13 PM
Details	Entity Name	Insert			Health Quarters	1/12/2017 3:13 PM
Details	Program Code	Insert			STD	1/12/2017 3:13 PM
Details	Entity Subname	Insert			Beverly Health Center	1/12/2017 3:13 PM
Dates	Participating Approval Date	Insert				1/12/2017 3:13 PM
Details	State	Insert			Pending	1/12/2017 3:13 PM
Dates	Registration Date	Insert			1/12/2017 12:00:00 AM	1/12/2017 3:13 PM
Dates	Signed By Date	Insert			1/12/2017 12:00:00 AM	1/12/2017 3:13 PM
Dates	Start Date	Insert				1/12/2017 3:13 PM
Terminations	Termination Comments	Insert				1/12/2017 3:13 PM
Terminations	Termination Date	Insert				1/12/2017 3:13 PM
Terminations	Termination Effective Date	Insert				1/12/2017 3:13 PM
Terminations	Termination Reason	Insert				1/12/2017 3:13 PM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History