MEDICARE: ERIC ALAN COVELY

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	332BC3200X	Customized Equipment (DME)	2731	OR

General Provider Information

NPI Number	:	1285805853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC ALAN COVELY

Provider Business Mailing Address
First Line	:	1613 OAK ST
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97401-4022
Country	:	US
Telephone Number	:	541-954-6809
Fax Number	:	541-343-8466

Provider Business Practice Location Address
First Line	:	1613 OAK ST
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97401-4022
Country	:	US
Telephone Number	:	541-954-6809
Fax Number	:	541-343-8466

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2008
Last Update Date	:	03/21/2008

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