Provider Demographics
NPI:1760650899
Name:COVENANT NURSING SERVICES LLC
Entity type:Organization
Organization Name:COVENANT NURSING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:C
Authorized Official - Last Name:WIREKO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:513-759-6165
Mailing Address - Street 1:7296 TARRAGON CT
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-5540
Mailing Address - Country:US
Mailing Address - Phone:513-759-6165
Mailing Address - Fax:513-759-6165
Practice Address - Street 1:7296 TARRAGON CT
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-5540
Practice Address - Country:US
Practice Address - Phone:513-759-6165
Practice Address - Fax:513-759-6165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty