COVENANT HOSPICE INC (NPI# 1093870594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093870594 |
| Entity Type | Organization |
| Organization Name | COVENANT HOSPICE INC |
| Practice Address |
4215 Kelson Ave Suite E Marianna FL 32446-6502 |
| Mailing Address |
5041 N 12th Ave Pensacola FL 32504-8916 |
| Practice Telephone | 8504828520 |
| Practice Fax Number | 8504828985 |
| Mailing Telephone | 8504332155 |
| Mailing Fax Number | 8502025819 |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2010-06-08 |
| Authorized Official Name | MR. DALE O KNEE (PRESIDENT CEO) |
| Authorized Official Telephone | 8504332155 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | 5025095 | FL | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE CROSS BLUE SHIELD | U20 | 01 |
| FL | 087517100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568527067 | Covenant Hospice Inc | Hospice Care, Community Based | 107 W 19th St, Panama City, FL 32405-4647 | 2006-12-26 |
| 1164587655 | Covenant Hospice Inc | Hospice Care, Community Based | 6479 Caroline St, Suite B, Milton, FL 32570-4590 | 2006-12-26 |
| 1366507865 | Covenant Hospice Inc | Hospice, Inpatient | 10075 Hillview Dr, Pensacola, FL 32514-5469 | 2006-12-26 |
| 1023173432 | Covenant Hospice Inc | Hospice Care, Community Based | 220 Eglin Pkwy Ne, Fort Walton Beach, FL 32547-2857 | 2006-12-26 |
| 1558426056 | Covenant Hospice Inc | Hospice Care, Community Based | 1921 Capital Cir Ne, Tallahassee, FL 32308-4492 | 2006-12-26 |
| 1194880690 | Covenant Hospice Inc | Hospice Care, Community Based | 3383 S Ferdon Blvd # B-5, Crestview, FL 32536-8484 | 2006-12-26 |
| 1841354974 | Covenant Hospice Inc | Hospice Care, Community Based | 3201 Dauphin St, Suite D, Mobile, AL 36606-4057 | 2006-12-21 |
| 1912061037 | Covenant Hospice Inc | Hospice Care, Community Based | 1023 Douglas Ave, Suite 204, Brewton, AL 36426-1586 | 2006-12-21 |
| 1801950910 | Covenant Hospice Inc | Hospice Care, Community Based | 1040 Stanton Road, Suite D, Daphne, AL 36526-4143 | 2006-12-21 |
| 1972555464 | Covenant Hospice Inc | Hospice Care, Community Based | 5041 N 12th Ave, Pensacola, FL 32504-8916 | 2006-05-16 |
| Street Address |
4215 KELSON AVE SUITE E |
| City | MARIANNA |
| State | FL |
| Zip Code | 32446-6502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033359781 | Patricia Lynn Benedict | Massage Therapist | 4215 Kelson Ave, Suitec, Marianna, FL 32446-8211 | 2009-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962054817 | Covenant Home Health Care, LLC | Home Health | 4540 Lafayette Street, Ste. G, Marianna, FL 32446 | 2019-07-11 |
| 1063902930 | Syntha Alvarez | Assistant Behavior Analyst | 3217 Highway 71, Marianna, FL 32446 | 2018-05-15 |
| 1922528926 | Charlotte Allen | Respite Care | 4326 Deering Street, Marianna, FL 32446 | 2017-06-21 |
| 1003352097 | Jonathan Lee | Physical Therapist | 4387 Kelson Ave Apt A, Marianna, FL 32446 | 2017-01-13 |
| 1386003192 | Harold B Parker | Nurse Practitioner | Sunland Center 3700 Williams Drive, Marianna, FL 32446 | 2016-02-22 |
| 1912372756 | John Tyler Ellerbee | Nurse Practitioner | 4215 E Kelson Ave, Marianna, FL 32446 | 2015-12-04 |
| 1902206790 | Jason Williams | Spec/Tech, Cardiovascular | 3625 Fci Road, Marianna, FL 32446 | 2014-08-28 |
| 1336558238 | Rocky Mountain Holdings, LLC | Ambulance | 3689 Industrial Park Dr, Marianna, FL 32446 | 2014-08-05 |
| 1831430826 | Jantzen Wayne Whitehead | Counselor | 2860 Highway 71 N, Suite A, Marianna, FL 32446 | 2013-03-15 |
| 1336498047 | Sharon Lynn Miller | Counselor | 2933 Madison Street, Marianna, FL 32446 | 2012-09-10 |
| Find all providers in zip 32446 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.