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General NPI Number Information
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NPI Number | 1568960862
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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 | 02/01/2018
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Last Update Date | 09/30/2019
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Provider Practice Location Address
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Address Line | 825 2ND AVE STE B2
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City | BOWLING GREEN
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State | KY
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Zip | 42101-1790
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Country | US
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Telephone | 270-796-3535
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Fax | 270-467-2609
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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 | 270-796-3535
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Fax | 270-467-2609
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Authorized Official
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Title or Position | EXEC. VICE PRESIDENT
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Name | RONALD GENE SOWELL
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Credential |
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Telephone | 270-745-1510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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