Organization
WELLMONT HEALTH SYSTEM
Active
Other names
LONESOME PINE HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE EDWIN HILTON (EVP/CFO)
(423) 302-3467
Entity
Organization
Contact information
Practice address
1990 HOLTON AVE E, BIG STONE GAP, VA 24219
(276) 523-3111
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(276) 523-3111
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000064909
KY BLUE CROSS
KY
05
—
004901142
—
VA
05
—
0166098400
—
KY
01
—
033385600
BLACK LUNG
TN
01
—
166592402
DEPT LABOR WORK COMP TN
TN
01
—
281670
ANTHEM
VA
05
—
3072953
—
TN
05
—
9810037000
—
WV
01
—
A2421917
UHC RIVER VALLEY
TN
05
—
A2421917
—
TN
Enumeration date
07/04/2006
Last updated
04/16/2024
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