Provider Demographics
NPI:1336706415
Name:ADVANCED TECHNOLOGY OF KENTUCKY INC.
Entity Type:Organization
Organization Name:ADVANCED TECHNOLOGY OF KENTUCKY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKWELDER
Authorized Official - Suffix:
Authorized Official - Credentials:COF
Authorized Official - Phone:513-383-2490
Mailing Address - Street 1:6325 MIAMI RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45243-3030
Mailing Address - Country:US
Mailing Address - Phone:513-383-2490
Mailing Address - Fax:800-303-1973
Practice Address - Street 1:233 THOMAS MORE PKWY
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3423
Practice Address - Country:US
Practice Address - Phone:859-331-0526
Practice Address - Fax:859-331-0602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies