Provider Demographics
NPI:1861818858
Name:COVENANT HEALTH INC
Entity type:Organization
Organization Name:COVENANT HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOY
Authorized Official - Middle Name:AYODELE
Authorized Official - Last Name:TEKOBO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:678-585-4962
Mailing Address - Street 1:1795 PRESIDENTIAL CIR
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-5644
Mailing Address - Country:US
Mailing Address - Phone:404-993-3381
Mailing Address - Fax:470-545-2234
Practice Address - Street 1:1795 PRESIDENTIAL CIR
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-5644
Practice Address - Country:US
Practice Address - Phone:404-993-3381
Practice Address - Fax:470-545-2234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-14
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0099953336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy