1619680980 NPI number — COVE RECOVERY, LLC FORMERLY J. DAVID COLLINS AND ASSOCIATES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619680980 NPI number — COVE RECOVERY, LLC FORMERLY J. DAVID COLLINS AND ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COVE RECOVERY, LLC FORMERLY J. DAVID COLLINS AND ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619680980
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
540 RIVERSIDE DR STE 8
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALISBURY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21801-5352
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-548-3333
Provider Business Mailing Address Fax Number:
410-548-3341

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10226 OLD OCEAN CITY BLVD UNIT 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERLIN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21811-1196
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-548-3333
Provider Business Practice Location Address Fax Number:
410-548-3341
Provider Enumeration Date:
01/03/2023

Additional Information

Authorized Official

Authorized Official Last Name:
HEATER
Authorized Official First Name:
KELSEY
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
410-548-3333

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 441198600 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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