| Convenient Care Collaboration Llc | |
|
5250 W Jefferson St Philadelphia PA 19131-3622 | |
| (267) 975-6765 | |
| (267) 200-0924 |
| Full Name | Convenient Care Collaboration Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5250 W Jefferson St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Sieda Barrow (CRNP/ PROVIDER) |
| Authorized Official Contact | 2679756765 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Convenient Care Collaboration Llc 5250 W Jefferson St Philadelphia PA 19131-3622 Ph: (267) 975-6765 | Convenient Care Collaboration Llc 5250 W Jefferson St Philadelphia PA 19131-3622 Ph: (267) 975-6765 |
| NPI Number | 1164938726 |
|---|---|
| Provider Enumeration Date | 12/19/2017 |
| Last Update Date | 03/08/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164938726 | NPI | - | NPPES |
| 1265634042 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | SP015976 (Pennsylvania) | Primary |
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