Healthcare Provider Details

I. General information

NPI: 1871393538
Provider Name (Legal Business Name): ADVANCED TECHNOLOGY OF KENTUCKY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 TEAYS VALLEY RD STE 6
HURRICANE WV
25526-9159
US

IV. Provider business mailing address

7570 US HIGHWAY 42
FLORENCE KY
41042-2324
US

V. Phone/Fax

Practice location:
  • Phone: 855-460-0956
  • Fax: 859-578-4828
Mailing address:
  • Phone: 859-578-4822
  • Fax: 859-578-4828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

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