| Covenant Primary & Behavioral Care | |
|
812 Candy Park Rd Ste 6101-a Pembroke NC 28372-9120 | |
| (910) 778-5455 | |
| (866) 423-7783 |
| Full Name | Covenant Primary & Behavioral Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 812 Candy Park Rd Ste 6101-a, Pembroke, North Carolina |
| Authorized Official Name and Position | William Joshua Johnson (CEO & PROVIDER) |
| Authorized Official Contact | 9107785455 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Covenant Primary & Behavioral Care Po Box 1629 Pembroke NC 28372-1629 Ph: (910) 778-5455 | Covenant Primary & Behavioral Care 812 Candy Park Rd Ste 6101-a Pembroke NC 28372-9120 Ph: (910) 778-5455 |
| NPI Number | 1346816667 |
|---|---|
| Provider Enumeration Date | 05/27/2021 |
| Last Update Date | 07/25/2022 |
| Medicare PECOS PAC ID | 2365840964 |
|---|---|
| Medicare Enrollment ID | O20211013000056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346816667 | NPI | - | NPPES |
| Provider Name | William Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578924130 PECOS PAC ID: 3678865367 Enrollment ID: I20160718001271 |
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