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DSH440039BN 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
Therapeutics Infusion Village at Vanderbilt - Infusion Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH440039BN
Medicare Provider Number
440039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/9/2024
Participating Start Date
4/1/2024
Participating Approval Date
2/14/2024
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Vanderbilt University Medical Center
James Edgar Newman, Vice President
(615) 293-3406
Primary Contact
Vanderbilt University Medical Center
Andrea Bryant, Vice President Pharmacy Business Operations
(615) 322-0711
Addresses
Street Address
1500 21ST AVENUE
1532
Nashville, TN 37212
Billing Address
Vanderbilt University Medical Center
1211 Medical Center Dr
Nashville, TN 37232
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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