Healthcare Provider Details

I. General information

NPI: 1396886537
Provider Name (Legal Business Name): VANDERBILT UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 COOLS SPRINGS BLVD.
FRANKLIN TN
37067
US

IV. Provider business mailing address

2146 BELCOURT AVENUE
NASHVILLE TN
37232-8792
US

V. Phone/Fax

Practice location:
  • Phone: 615-771-7265
  • Fax:
Mailing address:
  • Phone: 615-936-0471
  • Fax: 615-936-6095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE G. MIDGETT
Title or Position: DIRECTOR, PROVIDER SUPPORT SERVICES
Credential:
Phone: 615-936-0471