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DSH440039 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
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH440039
Medicare Provider Number
440039
Additional Details
Current Program Status
Active
Registration Date
4/28/2008
Participating Start Date
7/1/2002
Participating Approval Date
4/28/2008
Last Recertification Date
8/20/2024
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 MEDICAL CENTER DRIVE
NASHVILLE, TN 37232
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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4/10/12 UPDATED ENTITY NAME (WAS VANDERBILT UNIVERSITY MEDICAL CENTER), UPDATED MAIN ADD (REMOVED ROOM B 101VUH), ADDED SHIP ADD 3; REVISED MEDICAID #(WAS 9440817), ADDED NPI#;3/14/12 remove covered entitiy pharmacies and add as shipping addresses 1/5/09 UPDATED ADDR(WAS 1211 22ND AVENUE SOUTH); 7/25/06 UPDATED ADDR (WAS 1161 21ST AVE SOUTH)
04/10/2012
4/10/12 UPDATED MAIN ADD (REMOVED ROOM B 101VUH), ADDED SHIP ADD 3; REVISED MEDICAID #(WAS 9440817), ADDED NPI#;3/14/12 remove covered entitiy pharmacies and add as shipping addresses 1/5/09 UPDATED ADDR(WAS 1211 22ND AVENUE SOUTH); 7/25/06 UPDATED ADDR (WAS 1161 21ST AVE SOUTH)
04/10/2012
3/14/12 remove covered entitiy pharmacies and add as shipping addresses 1/5/09 UPDATED ADDR(WAS 1211 22ND AVENUE SOUTH); 7/25/06 UPDATED ADDR (WAS 1161 21ST AVE SOUTH)
03/14/2012
1/5/09 UPDATED ADDR(WAS 1211 22ND AVENUE SOUTH); 7/25/06 UPDATED ADDR (WAS 1161 21ST AVE SOUTH)
01/11/2010
May 2025
May 2025
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