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General NPI Number Information
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NPI Number | 1538455415
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Entity Type | Organization
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Legal Business Name | COMMONWEALTH HEALTH CORPORATION, INC
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Dates
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Enumeration Date | 06/20/2011
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Last Update Date | 12/08/2015
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Provider Practice Location Address
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Address Line | 825 2ND AVE SUITE C3
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City | BOWLING GREEN
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State | KY
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Zip | 42101-1786
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Country | US
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Telephone | 270-780-2660
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Fax | 270-780-2692
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Provider Business Mailing Address
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Address Line | PO BOX 2697
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City | BOWLING GREEN
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State | KY
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Zip | 42102-7697
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Country | US
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Telephone | 270-745-1100
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Fax | 270-745-1156
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | RONALD G. SOWELL
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Credential |
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Telephone | 270-745-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State | KY
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