# VANDERBILT INTEGRATED PROVIDERS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vanderbilt Integrated Internal Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164200747
- **Authorized official:** WENDY D MONACI (VICE PRESIDENT)
- **Authorized official phone:** (615) 936-3944

## Contact information

- **Practice address:** 1805 N JACKSON ST STE 100, TULLAHOMA, TN 37388-2291
- **Practice address phone:** (931) 455-7767
- **Practice address fax:** (931) 222-4057
- **Mailing address:** 3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/15/2023
- **Last updated:** 06/12/2024