A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Non-Pharmacy Dispensing Site |
332900000X | 87 | All Other Suppliers | |
Interventional Pain Medicine |
208VP0014X | 09 | Physician/Interventional Pain Management |
| NPI # | 1265183925 |
| LBN Legal business name | COMMONWEALTH PAIN ASSOCIATES PLLC |
| Authorized official | BRENDON COUGHTRY - (PARTNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 01/14/2022 |
| Last updated | 01/14/2022 - About 4 years ago |
| Identifiers | n/a |
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COMMONWEALTH PAIN ASSOCIATES PLLC
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