MEDICARE: CONVENIENTMD 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1508563800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONVENIENTMD LLC

Provider Business Mailing Address
First Line	:	111 NH AVE
Second Line	:
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-2864
Country	:	US
Telephone Number	:	603-410-6700
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 COMMERCIAL RD STE 2
Second Line	:
City	:	LEOMINSTER
State	:	MA
Zip	:	01453-3339
Country	:	US
Telephone Number	:	978-798-6896
Fax Number	:

Authorized Official
Title or Position	:	VP, REVENUE CYCLE MGT
Name	:	JAROD BOISSONNEAULT
Credential	:
Telephone Number	:	603-319-6223

Provider Enumeration Date	:	02/08/2023
Last Update Date	:	02/08/2023

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Directions to “CONVENIENTMD LLC ” Practice Location

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