Organization
WELLPATH COMMUNITY CARE CENTERS OF VIRGINIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC GOLDSTONE (PC OWNER)
(615) 551-6325
Entity
Organization
Contact information
Practice address
11049 WARWICK BLVD, NEWPORT NEWS, VA 23601-3226
(615) 258-8631
Mailing address
1283 MURFREESBORO PIKE, NASHVILLE, TN 37217-2432
(615) 258-8631
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
10/25/2021
Last updated
06/13/2022
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