Organization
COVENANT MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIE G UTTERBACK (VP FINANCIAL SERVICES)
(865) 374-5119
Entity
Organization
Contact information
Practice address
629 MIDDLE CREEK RD, SEVIERVILLE, TN 37862-5014
(865) 774-4440
(865) 774-4868
Mailing address
1400 CENTERPOINT BLVD, BLDG A, STE 202, KNOXVILLE, TN 37932-1979
(865) 374-5121
(865) 374-9004
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
27646
TN
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3734041
—
TN
Enumeration date
10/19/2010
Last updated
02/17/2016
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