MEDICARE: COVAN TESTING

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician
2	341600000X	Ambulance
3	3416L0300X	Land Ambulance
4	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1508446147
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COVAN TESTING

Provider Business Mailing Address
First Line	:	2301 SAN PEDRO DR NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-4119
Country	:	US
Telephone Number	:	505-303-0971
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 ALAMEDA BLVD NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87114-1953
Country	:	US
Telephone Number	:	505-585-1533
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. KEVIN B. KIRKPATRICK
Credential	:	MD
Telephone Number	:	505-948-4448

Provider Enumeration Date	:	04/08/2021
Last Update Date	:	04/08/2021

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Directions to “COVAN TESTING ” Practice Location

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