Organization
WELLMONT HEALTH SYSTEM
Active
Other names
Wellmont Madison House
Organization subpart
No
Provider details
NPI number
Authorized official
AMY MARIE GREGORY RN (DIRECTOR)
(423) 224-6900
Entity
Organization
Contact information
Practice address
2000 GREENWAY ST, KINGSPORT, TN 37660-3020
(423) 224-6900
(423) 224-3759
Mailing address
2000 GREENWAY STREET, KINGSPORT, TN 37660
(423) 224-6900
(423) 224-3759
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
I-01
TN
310400000X
Assisted Living Facility
ACL0000000155
TN
385H00000X
Respite Care
ACL0000000155
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100224722
S&U EXEMPT
TN
01
—
627479657
DUNNS NUMBER
TN
05
—
H445081
—
TN
01
—
V621P-3841
VETERANS AFFAIRS CONTRACT
TN
Enumeration date
05/16/2007
Last updated
01/09/2023
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