Provider Demographics
NPI:1528388196
Name:VANDERBILT UNIVERSITY MEDICAL CENTER
Entity Type:Organization
Organization Name:VANDERBILT UNIVERSITY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VPEC MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNIC
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:615-343-2230
Mailing Address - Street 1:1301 MEDICAL CENTER DR
Mailing Address - Street 2:TVC SUITE 1501
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0028
Mailing Address - Country:US
Mailing Address - Phone:615-343-2230
Mailing Address - Fax:
Practice Address - Street 1:1301 MEDICAL CENTER DR
Practice Address - Street 2:TVC SUITE 1501
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0028
Practice Address - Country:US
Practice Address - Phone:615-343-2230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000015011282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital