MEDICARE: COVETRUS NORTH AMERICA, LLC

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	3336M0002X	Mail Order Pharmacy
2	333600000X	Pharmacy

General Provider Information

NPI Number	:	1659972230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COVETRUS NORTH AMERICA, LLC

Provider Business Mailing Address
First Line	:	14800 FAA BLVD STE 150
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76155-2252
Country	:	US
Telephone Number	:	833-839-5428
Fax Number	:

Provider Business Practice Location Address
First Line	:	14800 FAA BLVD STE 150
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76155-2252
Country	:	US
Telephone Number	:	833-839-5428
Fax Number	:

Authorized Official
Title or Position	:	LICENSING AND CREDENTIALING ANALYST
Name	:	SUMMER ROPER
Credential	:
Telephone Number	:	623-340-9721

Provider Enumeration Date	:	11/02/2020
Last Update Date	:	02/27/2023

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