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NPI Code Detail

MEDICARE: DLP WILSON MEDICAL CENTER LLC

MEDICARE: DLP WILSON MEDICAL CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1467036848
Entity Type Code : Organization
Provider Name (Legal Business Name) : DLP WILSON MEDICAL CENTER LLC
Provider Business Mailing Address
First Line : 330 SEVEN SPRINGS WAY
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-5098
Country : US
Telephone Number : 615-920-7000
Fax Number :
Provider Business Practice Location Address
First Line : 1705 TARBORO ST SW
Second Line :
City : WILSON
State : NC
Zip : 27893-3437
Country : US
Telephone Number : 252-399-8040
Fax Number :
Authorized Official
Title or Position : ASSISTANT VICE PRESIDENT, SECRETARY
Name : KATHY TEAGUE
Credential :
Telephone Number : 615-920-7000
Provider Enumeration Date : 05/11/2021
Last Update Date : 05/11/2021

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Directions to “DLP WILSON MEDICAL CENTER LLC ” Practice Location

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