Covenant Health Ambulance Service, Inc

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

COVENANT HEALTH AMBULANCE SERVICE, INC

Practice address

1619B Weid Rd
Elgin, IL 60123-5825

Phone

(224) 856-5920

Fax

(224) 856-5806

NPI assigned

Mar 20, 2020

Last updated

Mar 20, 2020By 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

Queen Omoko

Title

Owner

Phone

(224) 856-5920

Specialties & licenses 1

Addresses

Other names 1

• COVENANT HEALTH AMBULANCE SERVICE, INC Former legal business name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1584662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584662400000",
    "number": "1821624966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619B WEID RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235825",
            "telephone_number": "224-856-5920",
            "fax_number": "224-856-5806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619B WEID RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235825",
            "telephone_number": "224-856-5920",
            "fax_number": "224-856-5806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT HEALTH AMBULANCE SERVICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-20",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A",
        "authorized_official_last_name": "OMOKO",
        "authorized_official_first_name": "QUEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-856-5920"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "Sharefile",
            "affiliation": "N",
            "endpointDescription": "IClour protected site",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Sharefile for data",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pdf",
            "address_1": "1619B WEID RD",
            "city": "ELGIN",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601235825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "COVENANT HEALTH AMBULANCE SERVICE, INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Christina Corona, MSN, RN
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• Ambulance in Elgin, IL
• Providers in Elgin, IL by specialty
• Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.