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General NPI Number Information
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NPI Number | 1497570980
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Entity Type | Organization
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Legal Business Name | COVENANT HOSPICE & PALLIATIVE CARE LLC
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 2630 WEST FWY STE 130
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City | FORT WORTH
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State | TX
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Zip | 76102-7117
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Country | US
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Telephone | 817-735-8741
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Fax |
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Provider Business Mailing Address
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Address Line | 10 CADILLAC DR STE 400
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City | BRENTWOOD
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State | TN
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Zip | 37027-1001
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Country | US
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Telephone | 417-841-4834
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Fax |
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Authorized Official
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Title or Position | SVP, CHIEF LEGAL OFFICER
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Name | RUSSELL ADKINS
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Credential |
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Telephone | 615-926-0340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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