Provider Demographics
NPI:1811188873
Name:HEALTHKEEPERZ, INC.
Entity Type:Organization
Organization Name:HEALTHKEEPERZ, INC.
Other - Org Name:COVENANT HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:BEACHER
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-522-0001
Mailing Address - Street 1:509 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-9546
Mailing Address - Country:US
Mailing Address - Phone:910-522-0001
Mailing Address - Fax:910-521-1049
Practice Address - Street 1:241 SINGLETON RIDGE RD
Practice Address - Street 2:SUITE B
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-8371
Practice Address - Country:US
Practice Address - Phone:843-347-5661
Practice Address - Fax:843-347-5667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC421563251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC421563Medicare Oscar/Certification