Healthcare Provider Details

I. General information

NPI: 1104331479
Provider Name (Legal Business Name): COMMONWEALTH HEALTH CORPORATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2017
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PARK ST
BOWLING GREEN KY
42101-1760
US

IV. Provider business mailing address

PO BOX 2697
BOWLING GREEN KY
42102-7697
US

V. Phone/Fax

Practice location:
  • Phone: 270-745-1111
  • Fax: 270-745-1026
Mailing address:
  • Phone: 270-745-1111
  • Fax: 270-745-1026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateNULL

VIII. Authorized Official

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