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DSH440039J 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
THE VANDERBILT CLINIC - COOL SPRINGS RHEUMATOLOGY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH440039J
Medicare Provider Number
440039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
9/15/2010
Participating Start Date
10/1/2010
Participating Approval Date
9/16/2010
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
2001 MALLORY LANE
SUITE 100
FRANKLIN, TN 37067
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 SUBDIV NAME (WAS VANDERBILT RHEUMATOLOGY COOL SPRINGS), ADDED SHIP ADD, ADDED BILL ADD, ADDED MEDICAID #
04/10/2012
April 2025
April 2025
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