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General NPI Number Information
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NPI Number | 1548288160
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Entity Type | Organization
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Legal Business Name | COVENANT MEDICAL CENTER INC
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 3421 W 9TH ST
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City | WATERLOO
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State | IA
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Zip | 50702-5401
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Country | US
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Telephone | 319-272-7303
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Fax | 319-272-7318
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Provider Business Mailing Address
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Address Line | 3421 W 9TH ST
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City | WATERLOO
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State | IA
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Zip | 50702-5401
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Country | US
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Telephone | 319-272-7304
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Fax | 319-272-7318
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Authorized Official
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Title or Position | CONTROLLER
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Name | TIMOTHY HUBER
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Credential |
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Telephone | 319-272-7607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 104100000X
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Taxonomy Name | Social Worker
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1878
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License Number State | IA
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