Healthcare Provider Details

I. General information

NPI: 1336706415
Provider Name (Legal Business Name): ADVANCED TECHNOLOGY OF KENTUCKY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2019
Last Update Date: 05/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 THOMAS MORE PKWY
CRESTVIEW HILLS KY
41017-3423
US

IV. Provider business mailing address

6325 MIAMI RD
CINCINNATI OH
45243-3030
US

V. Phone/Fax

Practice location:
  • Phone: 859-331-0526
  • Fax: 859-331-0602
Mailing address:
  • Phone: 513-383-2490
  • Fax: 800-303-1973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SCOTT BLACKWELDER
Title or Position: VICE PRESIDENT
Credential: COF
Phone: 513-383-2490