Organization
COVENANT ELDER HEALTH SERVICES & MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HIEP PHAM (PRESIDENT)
(704) 995-6643
Entity
Organization
Contact information
Practice address
2116 SAM WILSON RD, CHARLOTTE, NC 28214-9083
(704) 995-6643
Mailing address
PO BOX 78967, CHARLOTTE, NC 28271-7045
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
311ZA0620X
Adult Care Home Facility
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
05/29/2018
Last updated
05/29/2018
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