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General NPI Number Information
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NPI Number | 1740203140
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Entity Type | Organization
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Legal Business Name | VANDERBILT UNIVERSITY
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 1215 21ST AVE S STE 1006
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City | NASHVILLE
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State | TN
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Zip | 37232-0014
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Country | US
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Telephone | 615-936-1040
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Fax | 615-936-2289
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Provider Business Mailing Address
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Address Line | DEPT AT 40224
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City | ATLANTA
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State | GA
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Zip | 31192-0224
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Country | US
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Telephone | 615-343-6421
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Fax | 615-936-1893
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Authorized Official
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Title or Position | ASSIST DIRECTOR, PHARMACY
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Name | WALT WOODS
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Credential |
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Telephone | 615-322-4775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 976
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 976
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License Number State | TN
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