Healthcare Provider Details

I. General information

NPI: 1689747552
Provider Name (Legal Business Name): UNM HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 LOMAS BLVD., N.E.
ALBUQUERQUE NM
87106-2719
US

IV. Provider business mailing address

400 TIJERAS AVE NW STE 450
ALBUQUERQUE NM
87102-3273
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-1221
  • Fax: 505-272-1827
Mailing address:
  • Phone: 505-272-4275
  • Fax: 505-272-9991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number6005
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number6005
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number6005
License Number StateNM
# 5
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License NumberNM-10004-M
License Number StateNM
# 6
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number6005
License Number StateNM
# 8
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number6005
License Number StateNM
# 9
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number6005
License Number StateNM
# 10
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number6005
License Number StateNM
# 11
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 12
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State
# 13
Primary TaxonomyN
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License Number
License Number State
# 14
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State
# 15
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number6005
License Number StateNM

VIII. Authorized Official

Name: BONNIE MARIE WHITE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 505-272-1840