MEDICARE: COMMONWEALTH HAND THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1144806373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMONWEALTH HAND THERAPY

Provider Business Mailing Address
First Line	:	330 WALLER AVE STE 275
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-2930
Country	:	US
Telephone Number	:	859-447-8600
Fax Number	:	859-447-8599

Provider Business Practice Location Address
First Line	:	127 CLAY DR
Second Line	:
City	:	BEREA
State	:	KY
Zip	:	40403-1349
Country	:	US
Telephone Number	:	859-756-3281
Fax Number	:	859-756-3640

Authorized Official
Title or Position	:	PROVIDER/ OWNER
Name	:	DONALD GREGORY PITTS
Credential	:	OTR/L
Telephone Number	:	859-477-8600

Provider Enumeration Date	:	03/18/2021
Last Update Date	:	05/31/2023

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Directions to “COMMONWEALTH HAND THERAPY ” Practice Location

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