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NPI Code Detail

MEDICARE: ST. VINCENT HOSPITAL

MEDICARE: ST. VINCENT HOSPITAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518084128
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST. VINCENT HOSPITAL
Provider Business Mailing Address
First Line : 4001 RODEO RD
Second Line :
City : SANTA FE
State : NM
Zip : 87507-4830
Country : US
Telephone Number : 505-417-8994
Fax Number : 505-473-1274
Provider Business Practice Location Address
First Line : 4001 RODEO RD
Second Line :
City : SANTA FE
State : NM
Zip : 87507-4830
Country : US
Telephone Number : 505-471-8994
Fax Number : 505-473-1274
Authorized Official
Title or Position : CEO PRESIDENT
Name : J ALEX VALDEZ
Credential :
Telephone Number : 505-820-5227
Provider Enumeration Date : 03/26/2007
Last Update Date : 03/13/2012

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Directions to “ST. VINCENT HOSPITAL ” Practice Location

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