Organization
VANDERBILT UNIVERSITY
Active
Other names
Medical Center East Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WALT WOODS (ASSIST DIRECTOR, PHARMACY)
(615) 322-4775
Entity
Organization
Contact information
Practice address
1215 21ST AVE S STE 1006, NASHVILLE, TN 37232-0014
(615) 936-1040
(615) 936-2289
Mailing address
DEPT AT 40224, ATLANTA, GA 31192-0224
(615) 343-6421
(615) 936-1893
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
976
TN
3336S0011X
Specialty Pharmacy
976
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4424850
NCPDP
—
05
—
9449521
—
TN
01
—
976
TN PHARMACY LICENSE
TN
Enumeration date
07/26/2006
Last updated
06/21/2018
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