Healthcare Provider Details
I. General information
NPI: 1437507860
Provider Name (Legal Business Name): COMMONWEALTH HEALTH CORPORATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/26/2016
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
350 PARK ST STE 106
BOWLING GREEN KY
42101-1784
US
IV. Provider business mailing address
PO BOX 117914
ATLANTA GA
30368-7914
US
V. Phone/Fax
- Phone: 270-796-2557
- Fax: 270-796-2559
- Phone: 270-796-2557
- Fax: 270-796-2559
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086X0206X |
| Taxonomy | Surgical Oncology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
MICHELE
W
LAWLESS
Title or Position: EXECUTIVE VICE PRESIDENT & CFO
Credential:
Phone: 270-745-1500