Provider Demographics
NPI:1518434224
Name:COVENANT FAMILY HEALTH CARE
Entity Type:Organization
Organization Name:COVENANT FAMILY HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-373-1944
Mailing Address - Street 1:2017 STATE ROUTE 821 # B
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-5466
Mailing Address - Country:US
Mailing Address - Phone:740-373-1944
Mailing Address - Fax:740-373-1910
Practice Address - Street 1:2017 STATE ROUTE 821 # B
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-5466
Practice Address - Country:US
Practice Address - Phone:740-373-1944
Practice Address - Fax:740-373-1910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty