Covenant Community Care, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

COVENANT COMMUNITY CARE, INC.

Practice address

5716 Michigan Ave
Detroit, MI 48210-3039

Phone

(740) 764-4670

NPI assigned

Aug 12, 2026

Organization subpart

No

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

Authorized official

Name

Eric B. Blake

Title

Chief Compliance Officer

Phone

(740) 452-7685

Specialties & licenses 1

Addresses

Other names 1

• Covenant Pharmacy Doing business as

Tax ID family

Covenant Community Care Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Covenant Community Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
  • NPI 1255574265
  NPD tax ID
• Covenant Community Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
  • NPI 1558792937
  NPD tax ID
• Covenant Community Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
  • NPI 1689925075
  NPD tax ID
• Covenant Community Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
  • NPI 1770852634
  NPD tax ID

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

{
    "created_epoch": "1786492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786492800000",
    "number": "1437074192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5716 MICHIGAN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482103039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5716 MICHIGAN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482103039",
            "telephone_number": "740-764-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT COMMUNITY CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-12",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "740-452-7685"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covenant Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natasha Courts
• Kelly Cousino, CTRS
• Dominique Couture
• Karissa Ann Coutz
• Covenant Community Care, Inc.
• Covenant Community Care, Inc.
• Covenant Community Care, Inc.
• Covenant Community Care, Inc.
• Covenant Community Care, Inc.
• Covenant Community Care, Inc.

• Community/Retail Pharmacy in Detroit, MI
• Providers in Detroit, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.