Provider Demographics
NPI:1902425515
Name:COMMONHEALTH LLC
Entity Type:Organization
Organization Name:COMMONHEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MASHNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-806-3502
Mailing Address - Street 1:PO BOX 55522
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40555-5522
Mailing Address - Country:US
Mailing Address - Phone:859-806-3502
Mailing Address - Fax:502-661-1555
Practice Address - Street 1:1604 LOUISVILLE RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-3919
Practice Address - Country:US
Practice Address - Phone:502-661-1444
Practice Address - Fax:502-661-1555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-14
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty