| Vanderbilt Integrated Providers, Llc | |
|
1805 N Jackson St Ste 100 Tullahoma TN 37388-2291 | |
| (931) 455-7767 | |
| (931) 222-4057 |
| Full Name | Vanderbilt Integrated Providers, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1805 N Jackson St Ste 100, Tullahoma, Tennessee |
| Authorized Official Name and Position | Wendy D Monaci (VICE PRESIDENT) |
| Authorized Official Contact | 6159363944 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vanderbilt Integrated Providers, Llc 3841 Green Hills Village Dr Ste 200 Nashville TN 37215-2691 Ph: () - | Vanderbilt Integrated Providers, Llc 1805 N Jackson St Ste 100 Tullahoma TN 37388-2291 Ph: (931) 455-7767 |
| NPI Number | 1164200747 |
|---|---|
| Provider Enumeration Date | 09/15/2023 |
| Last Update Date | 06/12/2024 |
| Medicare PECOS PAC ID | 7012817919 |
|---|---|
| Medicare Enrollment ID | O20231020002834 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164200747 | NPI | - | NPPES |
| Q092315 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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Fast Pace Medical Clinic Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 N Jackson St, Tullahoma, TN 37388 Phone: 931-253-1110 | |
Tullahoma Spine & Wellness Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 111 Marbury Xing, Tullahoma, TN 37388 Phone: 931-455-0408 Fax: 931-454-9377 | |
Amg-southern Tennessee Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10054 Old Tullahoma Rd, Tullahoma, TN 37388 Phone: 931-455-6688 Fax: 931-455-0892 | |
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