Provider Demographics
NPI:1104411347
Name:COVENANTMD, LLC
Entity type:Organization
Organization Name:COVENANTMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ROHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-287-1983
Mailing Address - Street 1:930 RED ROSE CT STE 104
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-1981
Mailing Address - Country:US
Mailing Address - Phone:717-553-3090
Mailing Address - Fax:717-614-1000
Practice Address - Street 1:2811 N GEORGE ST STE A
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17406-3022
Practice Address - Country:US
Practice Address - Phone:717-210-4880
Practice Address - Fax:717-444-3751
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COVENANTMD, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty