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General NPI Number Information
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NPI Number | 1851046353
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Entity Type | Organization
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Legal Business Name | COVENANT CARE HEALTH SERVICES, LLC.
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 5551 ROSS RD
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City | MEMPHIS
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State | TN
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Zip | 38141-0445
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Country | US
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Telephone | 901-230-6886
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Fax |
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Provider Business Mailing Address
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Address Line | 5551 ROSS RD
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City | MEMPHIS
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State | TN
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Zip | 38141-0445
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Country | US
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Telephone | 901-230-6886
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PAULINE MICHELLE MAYS
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Credential | FNP
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Telephone | 901-230-6886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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