Healthcare Provider Details

I. General information

NPI: 1508704040
Provider Name (Legal Business Name): BRISTOL HOSPICE - NEW MEXICO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 INDIAN SCHOOL RD NE STE 160
ALBUQUERQUE NM
87110-4183
US

IV. Provider business mailing address

206 N 2100 W STE 202
SALT LAKE CITY UT
84116-4741
US

V. Phone/Fax

Practice location:
  • Phone: 505-337-0520
  • Fax: 505-717-7633
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ALEX MAURICIO
Title or Position: PRESIDENT & CEO
Credential:
Phone: 801-325-0175