Provider Demographics
NPI:1427195247
Name:COMMONWEALTH HEALTH CORP, INC.
Entity Type:Organization
Organization Name:COMMONWEALTH HEALTH CORP, INC.
Other - Org Name:QUICK CARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT & CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:W
Authorized Official - Last Name:LAWLESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-745-1500
Mailing Address - Street 1:P.O. BOX 2697
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-7697
Mailing Address - Country:US
Mailing Address - Phone:270-745-1100
Mailing Address - Fax:270-745-1156
Practice Address - Street 1:2435 NASHVILLE ROAD
Practice Address - Street 2:SUITE109
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-4030
Practice Address - Country:US
Practice Address - Phone:270-781-6164
Practice Address - Fax:270-781-2984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYPENDINGMedicaid
KY78900743Medicaid
KY00246Medicare PIN
KY78900743Medicaid