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Organization

VANDERBILT HEALTH PHARMACY GROUP LLC

Active
Other names
Vanderbilt Health Pharmacy Group
Organization subpart
No

Provider details

NPI number
Authorized official
JIM MANFRED (EXECUTIVE DIRECTOR)
(615) 322-4775
Entity
Organization

Contact information

Practice address
718 MELROSE AVE, NASHVILLE, TN 37211-2151
(888) 666-4992
(615) 242-1151
Mailing address
718 MELROSE AVE, NASHVILLE, TN 37211-2151
(888) 666-4992
(615) 242-1151

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
PCN.0003470
CT
3336S0011X
Specialty Pharmacy
0214002042
VA
3336S0011X
Specialty Pharmacy
036.0134164
VT
3336S0011X
Specialty Pharmacy
054.020796
IL
3336S0011X
Specialty Pharmacy
16879/7.1
MS
3336S0011X
Specialty Pharmacy
2018004878
MO
3336S0011X
Specialty Pharmacy
265500
MN
3336S0011X
Specialty Pharmacy
6012
TN
3336S0011X
Specialty Pharmacy
64002467A
IN
3336S0011X
Specialty Pharmacy
NR-51511
WY
3336S0011X
Specialty Pharmacy
NRP.022861300-03
OH
3336S0011X
Specialty Pharmacy
Primary
OSP.0007118
CO
3336S0011X
Specialty Pharmacy
PHA-MOP-LIC-52476
MT
3336S0011X
Specialty Pharmacy
PHNR001396
GA
3336S0011X
Specialty Pharmacy
TN2291
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2170126
PK
05
Q034038
TN
Enumeration date
06/26/2017
Last updated
09/19/2025
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