Healthcare Provider Details

I. General information

NPI: 1407040371
Provider Name (Legal Business Name): WELLPATH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1283 MURFREESBORO ROAD SUITE 500
NASHVILLE TN
37217
US

IV. Provider business mailing address

1283 MURFREESBORO ROAD SUITE 500
NASHVILLE TN
37217
US

V. Phone/Fax

Practice location:
  • Phone: 615-324-5750
  • Fax: 615-324-5751
Mailing address:
  • Phone: 615-324-5750
  • Fax: 615-324-5751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number11700
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: CODY SUTHERLAND
Title or Position: SENIOR REIMBURSEMENT SPECIALIST
Credential:
Phone: 615-312-7250