COVENANT COMMUNITY CARE, INC. (NPI# 1700377538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700377538 |
| Entity Type | Organization |
| Organization Name | COVENANT COMMUNITY CARE, INC. |
| Practice Address |
5716 Michigan Ave Detroit MI 48210-3039 |
| Mailing Address |
559 W Grand Blvd Detroit MI 48216-2200 |
| Practice Telephone | 3135540485 |
| Practice Fax Number | 3132280283 |
| Mailing Telephone | 3135540485 |
| Mailing Fax Number | 3132280283 |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2018-05-29 |
| Authorized Official Name | PAUL PROPSON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 3135540485 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528557105 | Covenant Community Care, Inc. | Optometrist | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2018-05-09 |
| 1689925075 | Covenant Community Care, Inc. | Clinic/Center | 20901 Moross Rd, Detroit, MI 48236-2058 | 2012-09-25 |
| 1073834818 | Covenant Community Care, Inc. | Clinic/Center | 27776 Woodward Ave, Royal Oak, MI 48067-0930 | 2010-06-16 |
| 1255574265 | Covenant Community Care, Inc. | Clinic/Center | 1700 Waterman St, Detroit, MI 48209-2022 | 2009-04-07 |
| 1720134943 | Covenant Community Care, Inc. | Clinic/Center | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2007-01-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COVENANT COMMUNITY CARE, INC. | 559 W Grand Blvd, Detroit, MI 48216-2200 |
| Street Address |
5716 MICHIGAN AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48210-3039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205827573 | Lisa J Mcintosh | Obstetrics & Gynecology | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2005-11-04 |
| 1891326625 | Gabriella Jamie Sanford | Social Worker | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2020-01-30 |
| 1972143782 | Joanna Veronica Dimas | Social Worker | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2020-01-09 |
| 1720621279 | Rachel Campbell | Nurse Practitioner | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2019-10-28 |
| 1326699752 | Carmensita J Buentello | Counselor | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2019-09-26 |
| 1316598329 | Disheka Denise Beverly-daniels | Social Worker | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2019-09-23 |
| 1912552449 | Katharine Nicole Marquez | Social Worker | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2019-08-01 |
| 1174183057 | Katherine Byl | Physician Assistant | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2019-06-13 |
| 1760955124 | Hawa A Haji-hassan | Student in an Organized Health Care Education/Training Program | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2019-01-09 |
| 1962975631 | Emma Jean Urbain | Social Worker | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2019-01-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518517606 | Southwest Solutions | Counselor | 5716 Michigan, Detroit, MI 48210 | 2019-09-19 |
| 1942676150 | Audrey Hall | Case Manager/Care Coordinator | 6576 Woodrow St, Detroit, MI 48210 | 2015-08-12 |
| 1952705147 | Barbara Denise Mccowin-west | Technician, Other | 6900 Mcgraw, Detroit, MI 48210 | 2014-10-16 |
| 1922259456 | Dawn Marie Sanderson | Counselor | 5613 Livernois, Detroit, MI 48210 | 2008-10-02 |
| 1366552804 | American Indian Health and Family Services of Southeastern Mi Inc | In Home Supportive Care | 4880 Lawndalestreet, Detroit, MI 48210 | 2006-08-30 |
| 1912950163 | Irwin Rabinowitz | Pharmacist | Junction Clinic Pharmacy 4771 Michigan Ave., Detroit, MI 48210 | 2006-05-18 |
| 1538305909 | Barbara Ann Menzies-williams | Internal Medicine | 6550 W Warren Ave, Detroit, MI 48210 | 2009-01-06 |
| 1760678437 | Clement T Piaskowski | Optometrist | 7433 Michigan Ave, Detroit, MI 48210 | 2007-09-17 |
| 1083804173 | Detroit Medical Centre | General Acute Care Hospital | 4201 St. Antoine, Detroit, MI 48210 | 2007-07-26 |
| 1205030277 | Renaissance Dental PC | Dentist | 7330 W Warren Ave, Detroit, MI 48210-1041 | 2007-06-13 |
| Find all providers in zip 48210 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427167196 | Springwells Clinical Pharmacy Inc. | Pharmacy | 2117 Springwells St, Detroit, MI 48209-1507 | 2006-08-29 |
| 1679737480 | Detroit Community Health Connection | Pharmacy | 7900 Kercheval St, Detroit, MI 48214-2439 | 2008-07-11 |
| 1447433842 | City of Detroit | Pharmacy | 3245 E Jefferson Ave Ste 100, Detroit, MI 48207-4222 | 2007-12-10 |
| 1669673745 | A&h Pharmacy Services | Pharmacy | 15000 Gratiot Ave, Suite 140, Detroit, MI 48205-1973 | 2007-05-29 |
| 1275676066 | Trinity Health Michigan | Pharmacy | 5555 Conner St, Suite 2691, Detroit, MI 48213-3448 | 2007-02-14 |
| 1275617599 | Community Health and Social Services Center, Inc. | Pharmacy | 5635 W Fort St, Detroit, MI 48209-3154 | 2006-10-24 |
| 1053351908 | Franklin Medical Pharmacy Inc | Pharmacy | 17950 Woodward Ave, Detroit, MI 48203-2260 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134744907 | Us Health Pharmaceuticals | Pharmacy | 23350 Greenfield Rd # 200b, Oak Park, MI 48237-2496 | 2020-06-08 |
| 1386286615 | Campus Drugs LLC | Pharmacy | 1065 N Huron River Dr Ste 600, Ypsilanti, MI 48197-3296 | 2019-10-08 |
| 1457850786 | Village Pharmacy Compounding 2 Inc | Pharmacy | 23077 Greenfield Rd Ste 100, Southfield, MI 48075-3744 | 2018-02-01 |
| 1225122724 | Blue Care Network of Michigan Pharmacy II | Pharmacy | 1401 S. Creyts Rd., Lansing, MI 48917 | 2006-10-02 |
| 1023059920 | Monroe Health Ventures, Inc | Pharmacy | 100 Powell Dr Suite 1, Dundee, MI 48131 | 2006-06-10 |
| 1861441768 | Pmc Pharmacy Inc | Pharmacy | 1241 W Broadway St, Three Rivers, MI 49093-8319 | 2006-05-08 |
| 1023654902 | Drug Store Inc | Pharmacy | 2236 Us Highway 23 S, Alpena, MI 49707-4544 | 2019-11-26 |
| 1033679071 | Quad/med, LLC | Pharmacy | 715 E Main St, Midland, MI 48640 | 2019-03-25 |
| 1619408424 | Peninsula Pharmacy Escanaba LLC | Pharmacy | 2500 7th Ave S, Ste 200, Escanaba, MI 49829-1292 | 2017-03-23 |
| 1467997239 | Little River Band of Ottawa Indians | Pharmacy | 2608 Government Center Dr, Manistee, MI 49660-8302 | 2017-01-03 |
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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.