Provider Demographics
NPI:1093748170
Name:COVENANT CLINICS, LLC
Entity Type:Organization
Organization Name:COVENANT CLINICS, LLC
Other - Org Name:COVENANT CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:575-842-2486
Mailing Address - Street 1:3961 E LOHMAN AVE
Mailing Address - Street 2:SUITE #33
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011
Mailing Address - Country:US
Mailing Address - Phone:575-556-0200
Mailing Address - Fax:575-556-0201
Practice Address - Street 1:3961 E LOHMAN AVE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011
Practice Address - Country:US
Practice Address - Phone:505-556-0200
Practice Address - Fax:505-527-1157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care