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General NPI Number Information
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NPI Number | 1366679276
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Entity Type | Organization
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Legal Business Name | VANDERBILT UNIVERSITY MEDICAL CENTER
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 06/18/2009
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Provider Practice Location Address
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Address Line | 1313 21ST AVE S 912 OXFORD HOUSE
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City | NASHVILLE
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State | TN
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Zip | 37232-0001
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Country | US
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Telephone | 615-936-0693
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Fax | 615-936-0697
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Provider Business Mailing Address
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Address Line | 1313 21ST AVE S 912 OXFORD HOUSE
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City | NASHVILLE
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State | TN
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Zip | 37232-0001
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Country | US
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Telephone | 615-936-0693
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Fax | 615-936-0697
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Authorized Official
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Title or Position | CLINICAL MANAGER
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Name | MS. JERITA PAYNE
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Credential |
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Telephone | 615-936-0431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 014107
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License Number State | TN
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