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General NPI Number Information
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NPI Number | 1760909378
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Entity Type | Organization
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Legal Business Name | COVENANT HOME HEALTHCARE
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Dates
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Enumeration Date | 08/24/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4614 RUNNYMEADE RD
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City | OWINGS MILLS
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State | MD
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Zip | 21117-6220
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Country | US
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Telephone | 240-353-1334
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Fax |
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Provider Business Mailing Address
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Address Line | 4614 RUNNYMEADE RD
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City | OWINGS MILLS
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State | MD
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Zip | 21117-6220
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Country | US
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Telephone | 240-353-1334
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | LAWRENCE OBATOMI
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Credential | MSN, RN
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Telephone | 240-353-1334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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