Provider Demographics
NPI:1871393538
Name:ADVANCED TECHNOLOGY OF KENTUCKY INC.
Entity type:Organization
Organization Name:ADVANCED TECHNOLOGY OF KENTUCKY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKWELDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-383-2490
Mailing Address - Street 1:7570 US HIGHWAY 42
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-2324
Mailing Address - Country:US
Mailing Address - Phone:859-578-4822
Mailing Address - Fax:859-578-4828
Practice Address - Street 1:3550 TEAYS VALLEY RD STE 6
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9159
Practice Address - Country:US
Practice Address - Phone:855-460-0956
Practice Address - Fax:859-578-4828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier