Organization
WELLMONT HEALTH SYSTEM
Active
Other names
HOLSTON VALLEY 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
130 W RAVINE RD, KINGSPORT, TN 37660
(423) 224-4000
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(423) 224-4000
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039632
UMWA IN-PATIENT
TN
01
—
0039640
UMWA OUT-PATIENT
TN
05
—
004400178
—
VA
05
—
0162200000
—
KY
05
—
0169767000
—
WV
01
—
036101100
BLACK LUNG
TN
05
—
0440017
—
TN
05
—
092263300
—
FL
05
—
100020304
—
TN
01
—
1000805
TN BLUE CROSS
TN
05
—
1000805
—
TN
01
—
166592401
POSTAL WORKERS DEPT OF LA
TN
05
—
1741825
—
LA
01
—
240866
ANTHEM BLUE CROSS
VA
05
—
4400017
—
NC
01
—
6530375
AETNA
TN
01
—
A3766001
UHC RIVER VALLEY
TN
05
—
A3766001
—
TN
Enumeration date
06/20/2006
Last updated
04/16/2024
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