# COVENANT PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** COVENANT PHARMACY LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851390892
- **Authorized official:** WILLIAM RICHARD WHITWELL PHARMD (MANAGER)
- **Authorized official phone:** (601) 326-5760

## Contact information

- **Practice address:** 371A HIGHLAND COLONY PKWY, RIDGELAND, MS 39157-6035
- **Practice address phone:** (601) 326-5760
- **Practice address fax:** (601) 326-5770
- **Mailing address:** 371A HIGHLAND COLONY PKWY, RIDGELAND, MS 39157-6035
- **Mailing address phone:** (601) 326-5760
- **Mailing address fax:** (601) 326-5770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 05087 | MS | Yes |

## Other

- **Enumeration date:** 07/20/2005
- **Last updated:** 02/04/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00330627 | — | MS |
| 01 | — | 2046319 | PK | — |