Provider Demographics
NPI:1114537362
Name:COVENANT WOMEN'S HEALTH PLLC
Entity Type:Organization
Organization Name:COVENANT WOMEN'S HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:EDILEOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKINDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-300-1216
Mailing Address - Street 1:PO BOX 270
Mailing Address - Street 2:
Mailing Address - City:SHANNON
Mailing Address - State:AL
Mailing Address - Zip Code:35142-0270
Mailing Address - Country:US
Mailing Address - Phone:059-626-0162
Mailing Address - Fax:205-894-7685
Practice Address - Street 1:801 ROAD TO SIX FLAGS W STE 116
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2615
Practice Address - Country:US
Practice Address - Phone:817-542-0833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-03
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty