Covenant Care Center of Paducah, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

4459 Issued in TX

Legal business name

COVENANT CARE CENTER OF PADUCAH, LLC

Practice address

800 7TH Street
Paducah, TX 79248

Phone

(806) 492-3516

Fax

(806) 492-2366

NPI assigned

Feb 7, 2007

Last updated

Oct 30, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ronald L Sanborn

Title

Managing Member

Phone

(832) 717-5519

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1093855355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16203 CHASEMORE DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773796603",
            "telephone_number": "832-717-5519",
            "fax_number": "832-717-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 7TH STREET",
            "city": "PADUCAH",
            "state": "TX",
            "postal_code": "79248",
            "telephone_number": "806-492-3516",
            "fax_number": "806-492-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT CARE CENTER OF PADUCAH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "SANBORN",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "832-717-5519"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "4459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Childress County Hospital District (Childress Regional Medical Center)
• County of Cottle (Paducah Ambulance Service)
• Hardeman County Memorial Hospital LLC (Hardeman County Memorial Hospital)
• Paducah Healthcare Providers, LLC (Paducah Nursing Center)
• Paducah Isd
• Paducah Senior Citizens Center Inc

• Skilled Nursing Facility in Paducah, TX
• Providers in Paducah, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.