Healthcare Provider Details

I. General information

NPI: 1992013114
Provider Name (Legal Business Name): COMMONWEALTH HEALTH CORPORATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2010
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 US 31W BYP
BOWLING GREEN KY
42101-1775
US

IV. Provider business mailing address

PO BOX 2697
BOWLING GREEN KY
42102-7697
US

V. Phone/Fax

Practice location:
  • Phone: 270-782-7768
  • Fax: 270-781-9480
Mailing address:
  • Phone: 270-782-7768
  • Fax: 270-781-9480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MICHELE LAWLESS
Title or Position: EXECUTIVE VICE PRESIDENT & CFO
Credential:
Phone: 270-745-1500