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Organization

COMMONWEALTH PAIN ASSOCIATES PLLC

Active
Other names
Commonwealth Pain And Spine
Organization subpart
No

Provider details

NPI number
Authorized official
JASON CARNES LEWIS (OWNER)
(502) 855-3919
Entity
Organization

Contact information

Practice address
3903 S 7TH ST STE 1A, TERRE HAUTE, IN 47802-5710
(812) 476-7111
(812) 476-7117
Mailing address
PO BOX 21890, BELFAST, ME 04915-4115
(502) 907-0356
(502) 919-9780

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300092797
IN
01
IN2373
MEDICARE PTAN
IN
Enumeration date
09/10/2024
Last updated
09/10/2024
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