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DSH440039BR Vanderbilt University Medical Center d/b/a Vanderbilt University Hospital and Clinic (Active)
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Main Details
Name
Vanderbilt University Medical Center d/b/a Vanderbilt University Hospital and Clinic
Subdivision Name
Colorectal Surgery MAB - Surgery
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH440039BR
Medicare Provider Number
440039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/10/2025
Participating Start Date
4/1/2025
Participating Approval Date
3/11/2025
Last Recertification Date
Contacts
Authorizing Official
Vanderbilt University Medical Center
James Edgar Newman, Vice President
(615) 293-3406
Primary Contact
DSH440039
Thomas Mark Sullivan, Chief Pharmacy Officer
(615) 343-9595
Addresses
Street Address
1211 21ST AVENUE
SUITE 220
Nashville, TN 37212
Billing Address
VANDERBILT UNIVERSITY HOSPITAL AND CLINIC
726 Melrose Ave
NASHVILLE, TN 37211-2151
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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