Vanderbilt Integrated Internal Medicine

LBN: Vanderbilt Integrated Providers, Llc
Vanderbilt Integrated Internal Medicine is an health care organization with primary practice located at 1805 N Jackson St Ste 100 , Tullahoma TN 37388-2291. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. Vanderbilt Integrated Providers, Llc can be contacted via phone (931) 455-7767, or through Monaci, Wendy D via phone (615) 936-3944.

Contact Information

Primary practice address
1805 N Jackson St Ste 100 Tullahoma TN 37388-2291
Phone: (931) 455-7767
Fax: (931) 222-4057
Website:
Map and Directions
Authorized official contact:
Name: Monaci, Wendy D
Phone: (615) 936-3944

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X

Profile Details

NPI number 1164200747
LBN Legal business name Vanderbilt Integrated Providers, Llc
DBA Doing business as Vanderbilt Integrated Internal Medicine
Authorized official Monaci, Wendy D
Entity Organization
Organization subpart 1 No
Enumeration date Sep 15th, 2023
Last updated Jun 12th, 2024 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164200747 NPPES
Tennessee MEDICAID Q092315

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