MEDICARE: CONVENIENT CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CJ4680	OTHER	LA	RAILROAD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164422630
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONVENIENT CARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 679632
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75267-9632
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12525 PERKINS RD
Second Line	:	SUITE B
City	:	BATON ROUGE
State	:	LA
Zip	:	70810-1907
Country	:	US
Telephone Number	:	225-819-8857
Fax Number	:	225-767-6822

Authorized Official
Title or Position	:	COO/PRESIDENT
Name	:	MR. STEVEN PAUL SELLARS
Credential	:
Telephone Number	:	225-214-9353

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	01/24/2023

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Directions to “CONVENIENT CARE LLC ” Practice Location

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