1245485200 NPI number — VANDERBILT UNIVERSITY MEDICAL CENTER

Table of content: (NPI 1245485200)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245485200 NPI number — VANDERBILT UNIVERSITY MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VANDERBILT UNIVERSITY MEDICAL CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245485200
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DD-2205 MCN
Provider Second Line Business Mailing Address:
VANDERBILT MEDICAL GENETICS
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37232-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-322-7602
Provider Business Mailing Address Fax Number:
615-343-9951

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
VANDERBILT MEDICAL GENETICS
Provider Second Line Business Practice Location Address:
DD-2205 MCN
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37232-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-322-7602
Provider Business Practice Location Address Fax Number:
615-343-9951
Provider Enumeration Date:
11/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
PFOTENHAUER
Authorized Official First Name:
JEAN
Authorized Official Middle Name:
PHYLLIS
Authorized Official Title or Position:
GENETIC COUNSELOR
Authorized Official Telephone Number:
615-322-7602

Provider Taxonomy Codes

  • Taxonomy code: 170300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com