St. Mary'S Health Wagon
Organization Active NPI Dental Clinic/Center · Wise, VA
NPI 1083324735 · NPPES record last updated Aug 12, 2024
Key facts
- NPI
- 1083324735
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- Legal business name
- ST. MARY'S HEALTH WAGON
- Practice address
- 5628 Patriot Drive
Wise, VA 24293 - Phone
- (276) 328-8850
- NPI assigned
- Dec 2, 2022
- Organization subpart
- No
Authorized official
- Name
- Paula Hill
- Title
- Clinical Director
- Phone
- (276) 337-0331
Corporate family (same tax ID) 2
Practitioners 3
-
Tauna Gulley, PHD, FNP, MSN
-
Teresa Tyson, FNP-BC
-
Henry Price Viers, FNP
National Provider Directory
- Tax ID family
- St Marys Health Wagon
Locations
116 Centre Ave NE
Coeburn, VA 24230
Phone (276) 231-0039
5628 Patriot Dr
Wise, VA 24293
Phone (276) 328-8850
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Yes |
Addresses
Primary practice location
5628 Patriot Drive
Wise, VA 24293
Mailing address
PO Box 7070
Wise, VA 24293-7070
Phone (276) 328-8850
Other providers in Wise, VA
- Safe Haven Enterprises, LLC
- Katie Scott
- Angela Stallard Short
- Dawn Short
- Dana Sibrel
- St. Mary'S Health Wagon
- St. Mary'S Pharmacy
- Olivia Stallard
- Autumn Marie Starnes
- Chritsopher T. Starnes
All providers in Wise, VA · Dental Clinic/Center in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.