Healthcare Provider Details

I. General information

NPI: 1144806373
Provider Name (Legal Business Name): COMMONWEALTH HAND THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2021
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 CLAY DR
BEREA KY
40403-1349
US

IV. Provider business mailing address

330 WALLER AVE STE 275
LEXINGTON KY
40504-2930
US

V. Phone/Fax

Practice location:
  • Phone: 859-756-3281
  • Fax: 859-756-3640
Mailing address:
  • Phone: 859-447-8600
  • Fax: 859-447-8599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DONALD GREGORY PITTS
Title or Position: PROVIDER/ OWNER
Credential: OTR/L
Phone: 859-477-8600