Vanderbilt Coffee Hospital, LLC
Internal Medicine in Tullahoma, TN. Organization (NPI-2).
NPI number1417543646
StatusActive
Last updated in NPPESAug 16, 2021
Details
- NPI
- 1417543646
- Entity type
- Organization (NPI-2)
- Legal business name
- Vanderbilt Coffee Hospital, LLC
- Organization subpart
- No
- Enumeration date
- Dec 11, 2020
- Certification date
- Aug 16, 2021
- Last updated
- Aug 16, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 208600000X | Surgery | – | – | |
| 208M00000X | Hospitalist | – | – | |
| 363L00000X | Nurse Practitioner | – | – | |
| 207Q00000X | Family Medicine | – | – | |
| 207V00000X | Obstetrics & Gynecology | – | – | |
| 207X00000X | Orthopaedic Surgery | – | – | |
| 208000000X | Pediatrics | – | – |
Practice location
1801 N Jackson StTullahoma, TN 37388-8259
Phone 931-393-3000
Mailing address
719 Thompson Ln Ste 30330Nashville, TN 37204-4701
Authorized official
Angela L Simmons
Vp - Finance
6159368875
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