Provider Demographics
NPI:1295618106
Name:COVERED BY CHUKWU
Entity type:Organization
Organization Name:COVERED BY CHUKWU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OUTREACH AND EQUITY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARAI
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-591-4546
Mailing Address - Street 1:3535 STARLING RD
Mailing Address - Street 2:
Mailing Address - City:MULLINS
Mailing Address - State:SC
Mailing Address - Zip Code:29574-7330
Mailing Address - Country:US
Mailing Address - Phone:843-591-4546
Mailing Address - Fax:
Practice Address - Street 1:3535 STARLING RD
Practice Address - Street 2:
Practice Address - City:MULLINS
Practice Address - State:SC
Practice Address - Zip Code:29574-7330
Practice Address - Country:US
Practice Address - Phone:843-591-4546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-28
Last Update Date:2025-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No282J00000XHospitalsReligious Nonmedical Health Care Institution
No251B00000XAgenciesCase Management
No374K00000XNursing Service Related ProvidersReligious Nonmedical PractitionerGroup - Multi-Specialty
No374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing PersonnelGroup - Multi-Specialty