Healthcare Provider Details

I. General information

NPI: 1659572915
Provider Name (Legal Business Name): COVENANT HOSPICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10075 HILLVIEW DR
PENSACOLA FL
32514-5469
US

IV. Provider business mailing address

10075 HILLVIEW DR
PENSACOLA FL
32514-5469
US

V. Phone/Fax

Practice location:
  • Phone: 850-484-3529
  • Fax: 850-202-0600
Mailing address:
  • Phone: 850-484-3529
  • Fax: 850-202-0600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateFL

VIII. Authorized Official

Name: MS. SUZANNE KELLEY
Title or Position: PHARMACIST
Credential: RPH, CPH
Phone: 850-433-2155