Organization
COVENANT MEDICAL CENTER
Active
Organization
COVENANT MEDICAL CENTER
Active
Other names
Covenant Health Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
3615 19TH ST FL 1, LUBBOCK, TX 79410-1203
(806) 725-7979
(806) 723-7979
Mailing address
PO BOX 677044, DALLAS, TX 75267-7044
(806) 725-7979
(806) 723-7979
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167733
PK
—
Enumeration date
02/07/2017
Last updated
05/09/2025
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