VANDERBILT INTEGRATED PROVIDERS, LLC; NPI #1891573473

Contact Information

VANDERBILT INTEGRATED PROVIDERS, LLC

1330 CEDAR LN STE 100
TULLAHOMA, TN 37388-2284

Phone: 931-393-3366
Fax: 931-393-1065
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rural Health	261QR1300X	B4[14]	Rural Health Clinic

Indicates primary specialty

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NPI Profile & details for VANDERBILT INTEGRATED PROVIDERS, LLC

NPI # 1891573473

LBN Legal business name VANDERBILT INTEGRATED PROVIDERS, LLC

Authorized official WENDY MONACI - (VICE PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 09/15/2023

Last updated 06/12/2024 - More than a year ago

Identifiers

Medicaid

Q92330

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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