Provider Demographics
NPI:1932718756
Name:COVETRUS NORTH AMERICA, LLC
Entity Type:Organization
Organization Name:COVETRUS NORTH AMERICA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSING AND CREDENTIALING ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:SUMMER
Authorized Official - Middle Name:
Authorized Official - Last Name:ROPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-340-9721
Mailing Address - Street 1:2401 W GRANDVIEW RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-3112
Mailing Address - Country:US
Mailing Address - Phone:844-205-9135
Mailing Address - Fax:
Practice Address - Street 1:2401 W GRANDVIEW RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-3112
Practice Address - Country:US
Practice Address - Phone:844-205-9135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy