Healthcare Provider Details

I. General information

NPI: 1518752559
Provider Name (Legal Business Name): COVENANT MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2025
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 SAINT FRANCIS DR STE 101
WATERLOO IA
50702-5633
US

IV. Provider business mailing address

3421 W 9TH ST
WATERLOO IA
50702-5401
US

V. Phone/Fax

Practice location:
  • Phone: 319-272-5700
  • Fax: 319-272-0188
Mailing address:
  • Phone: 319-272-7304
  • Fax: 319-272-7318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY HUBER
Title or Position: DIRECTOR FINANCIAL OPERATIONS
Credential:
Phone: 319-272-7607