Wellvana North Carolina, LLC
Exclusive Provider Organization in Nashville, TN. Organization (NPI-2).
NPI number1932829454
StatusActive
Last updated in NPPESMar 20, 2023
Details
- NPI
- 1932829454
- Entity type
- Organization (NPI-2)
- Legal business name
- Wellvana North Carolina, LLC
- Organization subpart
- No
- Enumeration date
- Sep 2, 2022
- Certification date
- Mar 20, 2023
- Last updated
- Mar 20, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302F00000X | Exclusive Provider Organization | – | – | Yes |
Practice location
20 Burton Hills Blvd Ste 100Nashville, TN 37215-6409
Phone 860-501-7908
Mailing address
4840 Centennial BlvdSte 202 Pmb 4
Nashville, TN 37209
Authorized official
Catherine Smith
Vp Operations
8605017908
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