Organization
CONVENIENT CARE MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA MARIE SIMS FNP-BC (OWNER/MANAGER)
(662) 241-7177
Entity
Organization
Contact information
Practice address
2207 5TH ST N, COLUMBUS, MS 39705-2211
(662) 251-3565
Mailing address
PO BOX 9051, COLUMBUS, MS 39705-0015
(662) 251-3565
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01903235
—
MS
Enumeration date
06/27/2015
Last updated
08/24/2022
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