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Organization
COMMONWEALTH BIOMEDICAL RESEARCH LLC
Active
Organization
COMMONWEALTH BIOMEDICAL RESEARCH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROLYN E WITTMER (OWNER/PRESIDENT)
(270) 825-8345
Entity
Organization
Contact information
Practice address
240 AYER PKWY E, MADISONVILLE, KY 42431-8999
(270) 825-8345
(270) 825-2975
Mailing address
240 EAST AYR PKWY, MADISONVILLE, KY 42431-8999
(270) 825-8345
(270) 825-2975
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
NULL
171100000X
Acupuncturist
—
—
1744R1102X
Research Study Specialist
—
NULL
1744R1102X
Research Study Specialist
—
—
207Q00000X
Family Medicine Physician
Primary
34849
KY
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
5766P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000599550
ANTHEM
—
01
—
000000599551
ANTHEM NP
—
01
—
18D0994667
CLIA
KY
05
—
6434849300
—
KY
Enumeration date
03/13/2007
Last updated
04/24/2013
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