Healthcare Provider Details

I. General information

NPI: 1285540450
Provider Name (Legal Business Name): WELLMONT HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 3RD ST NE STE 400
NORTON VA
24273-1137
US

IV. Provider business mailing address

311 PRINCETON RD STE 1
JOHNSON CITY TN
37601-2080
US

V. Phone/Fax

Practice location:
  • Phone: 276-679-9102
  • Fax:
Mailing address:
  • Phone: 423-434-3113
  • Fax: 423-431-1244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: SHANE HILTON
Title or Position: CFO
Credential:
Phone: 423-431-5794