Provider Demographics
NPI:1255950895
Name:COVENANT HEALTH DIAGNOSTIC CENTERS, LLC
Entity type:Organization
Organization Name:COVENANT HEALTH DIAGNOSTIC CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GEPPI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-374-6891
Mailing Address - Street 1:1420 CENTERPOINT BLVD BLDG C
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-1960
Mailing Address - Country:US
Mailing Address - Phone:865-374-3000
Mailing Address - Fax:
Practice Address - Street 1:210 FORT SANDERS WEST BLVD
Practice Address - Street 2:BLDG 3, SUITE 100
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3353
Practice Address - Country:US
Practice Address - Phone:865-531-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-14
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory