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General NPI Number Information
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NPI Number | 1518434224
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Entity Type | Organization
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Legal Business Name | COVENANT FAMILY HEALTH CARE
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Dates
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Enumeration Date | 10/31/2018
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Last Update Date | 10/31/2018
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Provider Practice Location Address
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Address Line | 2017 STATE ROUTE 821 # B
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City | MARIETTA
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State | OH
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Zip | 45750-5466
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Country | US
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Telephone | 740-373-1944
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Fax | 740-373-1910
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Provider Business Mailing Address
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Address Line | 2017 STATE ROUTE 821 # B
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City | MARIETTA
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State | OH
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Zip | 45750-5466
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Country | US
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Telephone | 740-373-1944
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Fax | 740-373-1910
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | PAMELA HUFF
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Credential |
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Telephone | 740-373-1944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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