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General NPI Number Information
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NPI Number | 1295313161
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Entity Type | Organization
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Legal Business Name | WELLMONT HEALTH SYSTEM
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Dates
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Enumeration Date | 03/31/2021
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 743 ISLAND RD
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City | BRISTOL
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State | VA
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Zip | 24201-7403
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Country | US
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Telephone | 276-469-4270
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Fax | 423-610-3364
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Provider Business Mailing Address
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Address Line | 2 PROFESSIONAL PARK DR STE 15
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City | JOHNSON CITY
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State | TN
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Zip | 37604-6584
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Country | US
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Telephone | 423-434-7443
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Fax | 423-302-3537
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Authorized Official
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Title or Position | EVP/CFO
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Name | SHANE EDWIN HILTON
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Credential |
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Telephone | 423-302-3467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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