Healthcare Provider Details

I. General information

NPI: 1932352283
Provider Name (Legal Business Name): VANDERBILT UNIVERSITY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2008
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 THOMPSON LN SUITE 24130
NASHVILLE TN
37204-3609
US

IV. Provider business mailing address

726 MELROSE AVE
NASHVILLE TN
37211-2151
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-2688
  • Fax: 615-322-0808
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number4593
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CECELIA MOORE
Title or Position: CFO AND TREASURER
Credential:
Phone: 615-322-0084