COVENANT VILLAGE PHARMACY LLC (NPI# 1548654056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548654056 |
| Entity Type | Organization |
| Organization Name | COVENANT VILLAGE PHARMACY LLC |
| Practice Address |
1351 Robinwood Rd Suite 1 Gastonia NC 28054-1693 |
| Practice Telephone | 7048672319 |
| Mailing Telephone | 7048672319 |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2015-03-23 |
| Authorized Official Name | JENNIFER ETHRIDGE (PRESIDENT/CEO) |
| Authorized Official Telephone | 7048672319 |
| Is Organization Subpart | Y |
| Parent Organization Name | DUNAWAYS, INC. |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
12540 | NC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | NC BOARD OF PHARMACY | 12540 | 01 |
| Street Address |
1351 ROBINWOOD RD SUITE 1 |
| City | GASTONIA |
| State | NC |
| Zip Code | 28054-1693 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154446474 | Cindy Hagan Stewart | Physical Therapy Assistant | 1351 Robinwood Rd, Gastonia, NC 28054-1693 | 2007-03-20 |
| 1407469836 | Kaiti Chandler | Speech-Language Pathologist | 1351 Robinwood Rd, Gastonia, NC 28054-1693 | 2020-08-25 |
| 1235773201 | P Bryan Askew Jr. | Occupational Therapy Assistant | 1351 Robinwood Rd, Gastonia, NC 28054-1693 | 2019-11-03 |
| 1649764747 | Carlie Turman | Physical Therapist | 1351 Robinwood Rd, Gastonia, NC 28054-1693 | 2018-06-21 |
| 1629573647 | Heather Moll | Occupational Therapy Assistant | 1351 Robinwood Rd, Gastonia, NC 28054-1693 | 2018-03-30 |
| 1629588736 | Gayle S Brezicki | Occupational Therapy Assistant | 1351 Robinwood Rd, Gastonia, NC 28054-1693 | 2017-10-03 |
| 1417304866 | Karla Skamperle | Occupational Therapy Assistant | 1351 Robinwood Rd, Gastonia, NC 28054-1693 | 2016-05-16 |
| 1205299799 | Casey Hunter Reep | Occupational Therapist | 1351 Robinwood Rd, Gastonia, NC 28054-1693 | 2016-04-01 |
| 1023413804 | Jennifer Weathers Ethridge | Pharmacist | 1351 Robinwood Rd, Box B-212, Gastonia, NC 28054-1693 | 2014-10-23 |
| 1225444698 | Joshua Johnson | Physical Therapist | 1351 Robinwood Rd, Gastonia, NC 28054-1693 | 2014-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671423 | Michaela Karsyn Morris | Behavioral Analyst | 2875 Court Dr. B, Gastonia, NC 28054 | 2019-10-21 |
| 1982263810 | Brenda Sue Fox | Occupational Therapist | Brian Center, 969 Cox Rd, Gastonia, NC 28054 | 2019-06-13 |
| 1174096911 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 469 Hospital Drive, Suite B1, Gastonia, NC 28054 | 2019-01-04 |
| 1255801817 | Jarae Mcswain | Counselor | 1558 Union Road, Ste F, Gastonia, NC 28054 | 2018-11-27 |
| 1427549807 | Alterman & Dhillon Charlotte Metro, Pplc | Dentist | 2205 E. Franklin Blvd, Ste 110, Gastonia, NC 28054 | 2018-05-22 |
| 1871083147 | Terrence Lamont Campbell | Dentist | 2641 Court Dr Ste A, Gastonia, NC 28054 | 2018-05-13 |
| 1861995367 | Jefferson and Jefferson LLC. | Respite Care | 945 East 6 Ave, Gastonia, NC 28054 | 2018-03-12 |
| 1790154912 | Tyler Adcock | Pharmacist | 2324 South New Hope Rd, Gastonia, NC 28054 | 2015-09-17 |
| 1922481894 | Alesha Nicole Logan | Nurse Practitioner | 1895 Hoffman Rd Ste A, Gastonia, NC 28054 | 2015-07-09 |
| 1457732596 | Buffie Baker Eller | Counselor | 2005 Flint Lane, Gastonia, NC 28054 | 2015-06-15 |
| Find all providers in zip 28054 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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|---|---|---|---|---|
| 1982236584 | Premier Pharmacy and Wellness Center LLC | Pharmacy | 3010 Monroe Rd Ste 101, Charlotte, NC 28205-7533 | 2020-02-11 |
| 1114564564 | Gaben | Pharmacy | 6602 Knightdale Blvd Ste 120, Knightdale, NC 27545-6567 | 2019-12-04 |
| 1316588346 | Nuevo Health, Inc | Pharmacy | 937 Old Knight Rd, Knightdale, NC 27545-9065 | 2019-10-01 |
| 1164987996 | Austin Drugs, Inc | Pharmacy | 3513 Suite B Highway 74 E, Monroe, NC 28110 | 2019-02-06 |
| 1326503657 | Village Pharmacy of Hampstead Inc | Pharmacy | 14057 Hwy 17, Suite 100, Hampstead, NC 28443 | 2019-01-31 |
| 1689148496 | Pharmscript of Nc LLC | Pharmacy | 140 Southcenter Ct Ste 600, Morrisville, NC 27560-8538 | 2019-01-15 |
| 1356812432 | Polaris Pharmacy Services of North Carolina, LLC | Pharmacy | 3300 Monroe Rd Unit E&f, Charlotte, NC 28205-7853 | 2018-12-16 |
| 1043799356 | Nelan LLC | Pharmacy | 3541 Randolph Rd Ste 104, Charlotte, NC 28211-1081 | 2018-08-08 |
| 1699280008 | The Script LLC | Pharmacy | 1450 Shaire Center Drive, Hudson, NC 28638 | 2017-12-07 |
| 1528592813 | Triad Choice Pharmacy | Pharmacy | 658 Waughtown St, Winston Salem, NC 27107-2217 | 2017-04-13 |
| Find all providers with the same taxonomy | ||||
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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.