1700800877 NPI number — VANDERBILT UNIVERSITY MEDICAL CENTER

Table of content: (NPI 1700800877)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700800877 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:
VANDERBILT CHILDRENS HOSPITAL PHARMACY
Provider Other Organization Name Type Code:
3
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:
1700800877
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/20/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2200 CHILDRENS WAY
Provider Second Line Business Mailing Address:
ROOM 2106A
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37232-9650
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-936-6337
Provider Business Mailing Address Fax Number:
615-936-4531

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 CHILDRENS WAY
Provider Second Line Business Practice Location Address:
ROOM 2106A
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37232-9650
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-936-6337
Provider Business Practice Location Address Fax Number:
615-936-4531
Provider Enumeration Date:
07/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WILLINGHAM
Authorized Official First Name:
HAROLD
Authorized Official Middle Name:
Authorized Official Title or Position:
DIR OF PHARMACY
Authorized Official Telephone Number:
615-936-4559

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336I0012X , with the licence number: 5804 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336S0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 2093997 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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