Organization
COVENANT HOSPICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROLAND CLENEAY (CFO)
(850) 433-2155
Entity
Organization
Contact information
Practice address
4215 KELSON AVE, SUITE E, MARIANNA, FL 32446-6502
(850) 482-8520
(850) 482-8985
Mailing address
5041 N 12TH AVE, PENSACOLA, FL 32504-8916
(850) 433-2155
(850) 202-5819
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
5025095
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
087517100
—
FL
01
—
U20
BLUE CROSS BLUE SHIELD
FL
Enumeration date
12/26/2006
Last updated
10/08/2021
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