Organization
COVENANT CONTRACT SERVICE
Active
Other names
Covenant Contract Service
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER J FANCETT (PRESIDENT)
(888) 510-1933
Entity
Organization
Contact information
Practice address
3939 S CHARLESTON PIKE, SPRINGFIELD, OH 45502-8385
(888) 510-1933
(888) 510-1932
Mailing address
3939 S CHARLESTON PIKE, SPRINGFIELD, OH 45502-8385
(888) 510-1933
(888) 510-1932
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
HMER23319
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0052155
—
OH
05
—
1203549
—
OH
01
—
557476
JOINT COMMISSION ACCREDITATION
OH
01
—
HMER 23319
OHIO RESPIRATORY CARE BOARD
OH
Enumeration date
02/05/2012
Last updated
08/06/2016
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