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COVENANT MEDICAL GROUP INC NPI 1881636488


NPI Information

NPI: 1881636488
Provider Name: COVENANT MEDICAL GROUP, INC
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization

CLIA Number: 44D0958200

Address:
1300 OLD WEISGARBER RD
KNOXVILLE, TN
ZIP 37909
Phone: (865) 584-2146
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COVENANT MEDICAL GROUP, INC is a durable medical equipment medical supplies in Knoxville, TN. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. COVENANT MEDICAL GROUP, INC NPI is 1881636488. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1300 OLD WEISGARBER RD
KNOXVILLE, TN
ZIP 37909-291
Phone: (865) 584-2146
Fax: (865) 584-9660

The provider's authorized official is Julie G Utterback .
The authorized official title is Vp Financial Services and has the following contact phone number (865) 374-5119.

The CLIA number assigned to this NPI record is 44D0958200 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 6/11/2006 and was last updated on 2/17/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineNo
2332B00000XDurable Medical Equipment & Medical SuppliesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
16516130004MEDICARE NSCTENNESSEE
23734041MEDICARE PINTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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