Healthcare Provider Details

I. General information

NPI: 1437219656
Provider Name (Legal Business Name): WELLSTAR HEALTH SYSTEM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 02/24/2020
Certification Date: 02/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 SANDY PLAINS RD
MARIETTA GA
30066-6340
US

IV. Provider business mailing address

805 SANDY PLAINS RD
MARIETTA GA
30066-6340
US

V. Phone/Fax

Practice location:
  • Phone: 770-792-7600
  • Fax:
Mailing address:
  • Phone: 770-792-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: MS. NICOLE ASHE
Title or Position: ASST. VP OF FINANCE
Credential:
Phone: 770-792-5261