Provider Demographics
NPI:1902062425
Name:TENNESSEE VALLEY HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:TENNESSEE VALLEY HEALTHCARE SERVICES
Other - Org Name:NASHVILLE VAMC
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR STEM CELL TRANSPLANT
Authorized Official - Prefix:DR
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-321-6373
Mailing Address - Street 1:1310 24TH AVE S # 11T
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-2637
Mailing Address - Country:US
Mailing Address - Phone:615-321-6373
Mailing Address - Fax:615-321-6374
Practice Address - Street 1:1310 24TH AVE S # 11T
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2637
Practice Address - Country:US
Practice Address - Phone:615-321-6373
Practice Address - Fax:615-321-6374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN135722865M2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital