Covenant Medical Center

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

COVENANT MEDICAL CENTER

Practice address

3615 19TH St FL 1
Lubbock, TX 79410-1203

Phone

(806) 725-7979

Fax

(806) 723-7979

NPI assigned

Feb 7, 2017

Organization subpart

No

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

Authorized official

Name

Donald W Anderson Jr.

Title

Assistant Secretary of Enrollments

Phone

(425) 358-9786

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Covenant Health Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Covenant Medical Center

  • General Acute Care Hospital
  • Lubbock, TX
  • NPI 1972517365

  4981943198

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Covenant Medical Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Covenant Medical Center

  • Cardiac Rehabilitation Clinic/Center
  • Lubbock, TX
  • NPI 1548878267
  NPD tax ID
• Covenant Medical Center

  • General Acute Care Hospital
  • Lubbock, TX
  • NPI 1972517365
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Methodist Children'S Hospital

  • Home Infusion Therapy Pharmacy
  • Lubbock, TX
  • NPI 1568451763

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elise Michella Johnson, PHARM D.

  • Pharmacist
  • Lubbock, TX
  • NPI 1467712026
  NPD (past)

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746748800000",
    "number": "1689112930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 677044",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752677044",
            "telephone_number": "806-725-7979",
            "fax_number": "806-723-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 19TH ST FL 1",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101203",
            "telephone_number": "806-725-7979",
            "fax_number": "806-723-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-07",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY OF ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167733",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covenant Health Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Covenant Health Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Covenant High Plains Surgery Center, LLC
• Covenant High Plains Surgery Center, LLC
• Covenant Long-Term Care LLC
• Covenant Long-Term Care, LP
• Covenant Medical Center
• Covenant Medical Center
• Covenant Medical Group
• Covenant Medical Group
• Covenant Rehabilitation Hospital of Lubbock LLC
• Covenant Rehabilitation Hospital of Lubbock LLC

• All providers in Lubbock, TX
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.