# WELLMONT WEXFORD HOUSE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WELLMONT HEALTH SYSTEM
- **Other names:** The Wexford House
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1134129075
- **Legal business name:** WELLMONT HEALTH SYSTEM
- **Authorized official:** SHANE EDWIN HILTON (EVP/CFO)
- **Authorized official phone:** (423) 302-3467

## Contact information

- **Practice address:** 2421 N JOHN B DENNIS HWY, KINGSPORT, TN 37660-4773
- **Practice address phone:** (423) 288-3988
- **Practice address fax:** (423) 288-3273
- **Mailing address:** 311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
- **Mailing address phone:** (423) 288-3988
- **Mailing address fax:** (423) 288-3273

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 265 | TN | — |
| 314000000X | Skilled Nursing Facility | 265 | TN | Yes |

## Other

- **Enumeration date:** 07/21/2005
- **Last updated:** 04/16/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7440529 | — | TN |