Provider Demographics
NPI:1932265063
Name:COVENANT HEALTHCARE,LLC
Entity Type:Organization
Organization Name:COVENANT HEALTHCARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:RAMEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:252-791-0083
Mailing Address - Street 1:115 E WATER ST
Mailing Address - Street 2:PO BOX 186
Mailing Address - City:PLYMOUTH
Mailing Address - State:NC
Mailing Address - Zip Code:27962-1329
Mailing Address - Country:US
Mailing Address - Phone:252-791-0083
Mailing Address - Fax:252-791-0086
Practice Address - Street 1:115 E WATER ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NC
Practice Address - Zip Code:27962-1329
Practice Address - Country:US
Practice Address - Phone:252-791-0083
Practice Address - Fax:252-791-0086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered251E00000XAgenciesHome Health
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601609Medicaid