CONVENIENT CARE COLLABORATION LLC NPI 1164938726

NPI Information

NPI: 1164938726
Provider Name: CONVENIENT CARE COLLABORATION LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
5250 W JEFFERSON ST
PHILADELPHIA, PA
ZIP 19131
Phone: (267) 975-6765
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CONVENIENT CARE COLLABORATION LLC is a family medicine in Philadelphia, PA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. CONVENIENT CARE COLLABORATION LLC NPI is 1164938726. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5250 W JEFFERSON ST
PHILADELPHIA, PA
ZIP 19131-622
Phone: (267) 975-6765
Fax: (267) 200-0924

The provider's authorized official is Sieda Barrow .
The authorized official title is Crnp/ Provider and has the following contact phone number (267) 975-6765.

The enumeration date for this NPI number is 12/19/2017 and was last updated on 3/8/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		SP015976	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1265634042	MEDICAID	PENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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