Provider Demographics
NPI:1467661363
Name:COVENANT HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:COVENANT HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:BENEDICT
Authorized Official - Middle Name:CHUKWUMA
Authorized Official - Last Name:ODIRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-725-4080
Mailing Address - Street 1:880 QUITMAN DR E
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-2076
Mailing Address - Country:US
Mailing Address - Phone:614-572-6792
Mailing Address - Fax:614-532-0748
Practice Address - Street 1:1378 E LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2922
Practice Address - Country:US
Practice Address - Phone:614-725-4080
Practice Address - Fax:614-725-4063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty