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NPI Code Detail

MEDICARE: VANDERBILT UNIVERSITY MEDICAL CENTER

MEDICARE: VANDERBILT UNIVERSITY MEDICAL CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336S0011XSpecialty PharmacyA9-0001840DE
23336S0011XSpecialty PharmacyPHNR000936GA
33336S0011XSpecialty PharmacyPH30108FL
43336S0011XSpecialty Pharmacy22-104210KS
53336S0011XSpecialty Pharmacy054.019599IL
63336S0011XSpecialty Pharmacy43401MSID
73336S0011XSpecialty PharmacyPHY.007524-NRLA
83336S0011XSpecialty Pharmacy4544IA
93336S0011XSpecialty Pharmacy2017028388MO
103336S0011XSpecialty Pharmacy265180MN
113336S0011XSpecialty PharmacyTN2112KY
123336S0011XSpecialty Pharmacy64002111AIN
133336S0011XSpecialty PharmacyPCN.0003412CT
143336S0011XSpecialty PharmacyP07724MD
153336S0011XSpecialty Pharmacy114507AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12149461OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679971485
Entity Type Code : Organization
Provider Name (Legal Business Name) : VANDERBILT UNIVERSITY MEDICAL CENTER
Provider Business Mailing Address
First Line : 726 MELROSE AVE
Second Line :
City : NASHVILLE
State : TN
Zip : 37211-2151
Country : US
Telephone Number : 615-875-6000
Fax Number : 615-242-1151
Provider Business Practice Location Address
First Line : 726 MELROSE AVE
Second Line :
City : NASHVILLE
State : TN
Zip : 37211-2151
Country : US
Telephone Number : 615-875-6000
Fax Number : 615-242-1151
Authorized Official
Title or Position : CHIEF PHARMACY OFFICER
Name : MARK SULLIVAN
Credential :
Telephone Number : 615-343-9595
Provider Enumeration Date : 12/10/2014
Last Update Date : 08/13/2025

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