Organization
WELLMONT HEALTH SYSTEM
Active
Other names
BRISTOL REGIONAL MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE EDWIN HILTON (EVP/CFO)
(423) 302-3467
Entity
Organization
Contact information
Practice address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(423) 844-1121
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(423) 844-1121
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004400127
—
VA
01
—
033361400
BLACK LUNG
TN
05
—
0440012
—
TN
05
—
100020309
—
TN
01
—
1000319
TN BLUE CROSS
TN
05
—
10260B
—
SC
01
—
1377051
UMWA
TN
01
—
166592403
POSTAL WORKERS DEPT LAB
TN
01
—
240867
ANTHEM
VA
01
—
6530115
AETNA
TN
01
—
A3762106
UHC RIVER VALLEY
TN
05
—
A3762106
—
TN
Enumeration date
07/03/2006
Last updated
04/16/2024
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