MEDICARE: COVENANT MEDICAL CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital	730061	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00275	OTHER	MI	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588656946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COVENANT MEDICAL CENTER, INC.

Provider Business Mailing Address
First Line	:	1447 N HARRISON ST
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48602-4727
Country	:	US
Telephone Number	:	989-583-6100
Fax Number	:	989-583-2889

Provider Business Practice Location Address
First Line	:	1447 N HARRISON ST
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48602-4727
Country	:	US
Telephone Number	:	989-583-0000
Fax Number	:	989-583-2727

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. MARGARET MAINE
Credential	:
Telephone Number	:	989-583-6100

Provider Enumeration Date	:	08/21/2005
Last Update Date	:	03/15/2019

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