Healthcare Provider Details

I. General information

NPI: 1184558363
Provider Name (Legal Business Name): ST VINCENT HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7910 WYOMING BLVD NE STE A
ALBUQUERQUE NM
87109-6031
US

IV. Provider business mailing address

455 SAINT MICHAELS DR
SANTA FE NM
87505-7663
US

V. Phone/Fax

Practice location:
  • Phone: 505-913-8600
  • Fax: 505-913-6780
Mailing address:
  • Phone: 505-913-3093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: HOPE WADE
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 928-607-0495