Healthcare Provider Details

I. General information

NPI: 1437304474
Provider Name (Legal Business Name): WELLMONT HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9480 HIGHWAY 805
JENKINS KY
41537-8182
US

IV. Provider business mailing address

1 MEDICAL PARK BLVD
BRISTOL TN
37620-7430
US

V. Phone/Fax

Practice location:
  • Phone: 606-832-2171
  • Fax:
Mailing address:
  • Phone: 423-844-4711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER D KNIGHT
Title or Position: EXEC VP/CFO
Credential:
Phone: 423-230-8200