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General NPI Number Information
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NPI Number | 1861769606
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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 | 11/22/2011
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Last Update Date | 11/22/2011
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Provider Practice Location Address
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Address Line | 1670 W MAIN ST
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City | LEBANON
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State | TN
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Zip | 37087-1344
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Country | US
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Telephone | 615-453-5155
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Fax | 615-444-5915
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Provider Business Mailing Address
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Address Line | 4163 VILLAGE AT VANDERBILT
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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 | 615-322-3573
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Fax | 615-936-6095
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. DANIELLE MIDGETT
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Credential |
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Telephone | 615-936-0471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State | TN
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