Healthcare Provider Details

I. General information

NPI: 1720914773
Provider Name (Legal Business Name): AMERICAN COVENANT HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 DAVIDSON AVE
SOMERSET NJ
08873-4149
US

IV. Provider business mailing address

220 DAVIDSON AVE
SOMERSET NJ
08873-4149
US

V. Phone/Fax

Practice location:
  • Phone: 347-870-9853
  • Fax: 833-542-9030
Mailing address:
  • Phone: 347-870-9853
  • Fax: 833-542-9030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: FAROOQ ALI
Title or Position: PRESIDENT
Credential:
Phone: 347-870-9853