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General NPI Number Information
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NPI Number | 1467449181
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Entity Type | Organization
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Legal Business Name | COVENANT HOMECARE
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 12/18/2014
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Provider Practice Location Address
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Address Line | 3001 LAKE BROOK BLVD SUITE 101
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City | KNOXVILLE
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State | TN
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Zip | 37909-1100
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Country | US
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Telephone | 865-374-0600
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Fax | 865-374-2061
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Provider Business Mailing Address
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Address Line | 3001 LAKE BROOK BLVD SUITE 101
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City | KNOXVILLE
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State | TN
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Zip | 37909-1100
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Country | US
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Telephone | 865-374-0600
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Fax | 865-374-2024
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. JOHN HUSKEY
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Credential |
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Telephone | 865-374-0602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 0000000364
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License Number State | TN
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