| Wellmont Health System | |
|
1 Medical Park Blvd Bristol TN 37620 | |
| (423) 844-1121 | |
| Not Available |
| Full Name | Wellmont Health System |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1 Medical Park Blvd, Bristol, Tennessee |
| Authorized Official Name and Position | Shane Edwin Hilton (EVP/CFO) |
| Authorized Official Contact | 4233023467 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellmont Health System 311 Princeton Rd Ste 1 Johnson City TN 37601-2026 Ph: (423) 844-1121 | Wellmont Health System 1 Medical Park Blvd Bristol TN 37620 Ph: (423) 844-1121 |
| NPI Number | 1558391045 |
|---|---|
| Provider Enumeration Date | 07/03/2006 |
| Last Update Date | 04/16/2024 |
| Certification Date | 04/16/2024 |
| Medicare PECOS PAC ID | 2567360704 |
|---|---|
| Medicare Enrollment ID | O20080909000324 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558391045 | NPI | - | NPPES |
| 3162433 | Other | TN | TN BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
Ipc Pac Healthcare Services Of Tennessee Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1 Medical Park Blvd, Bristol, TN 37620 Phone: 423-844-1121 | |
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