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DSH440039Z 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- PSYCHIATRY CLINIC AT VPH
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH440039Z
Medicare Provider Number
440039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/15/2013
Participating Start Date
4/1/2013
Participating Approval Date
3/1/2013
Last Recertification Date
8/21/2024
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
1601 23RD AVE
SUITE 300
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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