Organization
COVENANT HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA LEE LEVENGOOD MBA, RN (EXECUTIVE DIRECTOR)
(800) 726-8761
Entity
Organization
Contact information
Practice address
1223 POTTSVILLE PIKE, SHOEMAKERSVILLE, PA 19555-1719
(800) 726-8761
(570) 385-5287
Mailing address
1223 POTTSVILLE PIKE, SHOEMAKERSVILLE, PA 19555-1719
(800) 726-8761
(570) 385-5287
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
712905
PA
251G00000X
Community Based Hospice Care Agency
Primary
159199
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100773957
—
PA
05
—
1007739570007
—
PA
05
—
1007739570008
—
PA
01
—
1722
BLUE SHIELD PROVIDER NO.
PA
01
—
30892
GEISINGER PROVIDER NUMBER
PA
01
—
397129
BLUE CROSS PROVIDER NO.
PA
01
—
70354200
BLACK LUNG PROVIDER NO.
PA
01
—
C397129
GATEWAY PROVIDER NUMBER
PA
Enumeration date
10/13/2006
Last updated
10/04/2011
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