Provider Demographics
NPI:1659738383
Name:VANDERBILT UNIVERSITY MEDICAL CENTER
Entity Type:Organization
Organization Name:VANDERBILT UNIVERSITY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE CHANCELLOR FOR HEALTH AFFAIRS
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:WRIGHT
Authorized Official - Last Name:PINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-936-2000
Mailing Address - Street 1:719 THOMPSON LN STE 30330
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-4701
Mailing Address - Country:US
Mailing Address - Phone:615-936-2000
Mailing Address - Fax:615-936-6065
Practice Address - Street 1:1670 W MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-1345
Practice Address - Country:US
Practice Address - Phone:615-453-5155
Practice Address - Fax:615-444-5915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN10370G9222Medicare PIN