Basic Information
| Provider Information | |||||||||
| NPI: | 1831244466 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COVENANT MEDICAL CENTER, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1447 N HARRISON ST | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486024727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9895836100 | ||||||||
| FaxNumber: | 9895832889 | ||||||||
| Practice Location | |||||||||
| Address1: | 5570 STATE ST | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486033583 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9895830100 | ||||||||
| FaxNumber: | 9895830108 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2007 | ||||||||
| LastUpdateDate: | 03/15/2019 | ||||||||
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| AuthorizedOfficialLastName: | MAINE | ||||||||
| AuthorizedOfficialFirstName: | MARGARET | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9895836100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
ID Information
| ID | Type | State | Issuer | Description | 700G310560 | 01 | MI | BCBS/BCN | OTHER | 700G310950 | 01 | MI | BCBS | OTHER |