Organization
WELLVANA NORTH CAROLINA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE SMITH (VP OPERATIONS)
(860) 501-7908
Entity
Organization
Contact information
Practice address
20 BURTON HILLS BLVD STE 100, NASHVILLE, TN 37215-6409
(860) 501-7908
Mailing address
4840 CENTENNIAL BLVD, STE 202 PMB 4, NASHVILLE, TN 37209
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
09/02/2022
Last updated
03/20/2023
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