Covenant Food Stores Inc.

Primary specialty

PharmacistTaxonomy code 183500000X

License

P04006 Issued in MD

Legal business name

COVENANT FOOD STORES INC.

Doing business as

covenant pharmacy/grocery

Practice address

14633 Baltimore Ave
Laurel, MD 20707-4902

Phone

(301) 362-9100

Fax

(301) 362-9138

NPI assigned

Jul 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Collinwise Osei-Aboagye, RPH

Title

Pharmacist/President

Phone

(301) 362-9100

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• covenant pharmacy/grocery Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043244205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14633 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074902",
            "telephone_number": "301-362-9100",
            "fax_number": "301-362-9138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14633 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074902",
            "telephone_number": "301-362-9100",
            "fax_number": "301-362-9138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT FOOD STORES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OSEI-ABOAGYE",
        "authorized_official_first_name": "COLLINWISE",
        "authorized_official_title_or_position": "PHARMACIST/PRESIDENT",
        "authorized_official_telephone_number": "301-362-9100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "P04006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00111850",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2127214",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "covenant pharmacy/grocery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacist in Laurel, MD
• Providers in Laurel, MD by specialty
• Pharmacist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.