MEDICARE: VANDERBILT UNIVERSITY MEDICAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	273R00000X	Psychiatric Hospital Unit

General Provider Information

NPI Number	:	1821030842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VANDERBILT UNIVERSITY MEDICAL CENTER

Provider Business Mailing Address
First Line	:	3841 GREEN HILLS VILLAGE DR STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2691
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 PARK AVENUE
Second Line	:
City	:	LEBANON
State	:	TN
Zip	:	37087-3721
Country	:	US
Telephone Number	:	615-449-0500
Fax Number	:	615-453-7405

Authorized Official
Title or Position	:	CFO AND TREASURER
Name	:	CECELIA B. MOORE
Credential	:
Telephone Number	:	615-322-0084

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	03/31/2022

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