Organization
COMMONWEALTH PAIN ASSOCIATES PLLC
Active
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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