Organization
COVENANT HOSPICE INC
Active
Parent organization
COVENANT HOSPICE INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
COVENANT HOSPICE INC
Authorized official
MR. ROLAND CLENEAY (CFO)
(850) 433-2155
Entity
Organization
Contact information
Practice address
3383 S FERDON BLVD # B-5, CRESTVIEW, FL 32536-8484
(850) 682-3628
(850) 682-8434
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
10/10/2021
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