National Provider Identifier Database

VANDERBILT INTEGRATED PROVIDERS LLC
Rural Health


Contact Information

VANDERBILT INTEGRATED PROVIDERS, LLC
1805 N JACKSON ST STE 100
TULLAHOMA, TN37388-2291
Phone: 931-455-7767
Fax: 931-222-4057
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X

* Indicates primary specialty

NPI Profile & details for VANDERBILT INTEGRATED PROVIDERS, LLC

NPI Number 1164200747
Legal business name
LBN
VANDERBILT INTEGRATED PROVIDERS, LLC
Authorized official WENDY MONACI - (VICE PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 09/15/2023
Last updated 06/12/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • TN Medicaid: Q092315

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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