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General NPI Number Information
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NPI Number | 1093276370
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Entity Type | Organization
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Legal Business Name | CONVENIENTMD LLC
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Dates
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Enumeration Date | 03/28/2019
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 193 BATH ROAD
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City | BRUNSWICK
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State | ME
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Zip | 04011
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Country | US
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Telephone | 207-424-2272
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Fax |
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Provider Business Mailing Address
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Address Line | 360 US HIGHWAY 1 BYP UNIT 102
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City | PORTSMOUTH
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State | NH
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Zip | 03801-7105
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Country | US
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Telephone | 603-410-6700
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Fax | 603-319-8308
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Authorized Official
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Title or Position | EXECUTIVE CHAIRMAN
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Name | GARETH DICKENS
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Credential |
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Telephone | 603-501-0863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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