Healthcare Provider Details
I. General information
NPI: 1760308068
Provider Name (Legal Business Name): COVENANT COMPANY CHILTON
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
303 1ST ST N
CLANTON AL
35045-3418
US
IV. Provider business mailing address
303 1ST ST N
CLANTON AL
35045-3418
US
V. Phone/Fax
- Phone: 205-280-3333
- Fax: 205-280-4135
- Phone: 205-280-3333
- Fax: 205-280-4135
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RACHEL
JOHNSON
MILLER
Title or Position: OWNER
Credential:
Phone: 205-280-3333