Healthcare Provider Details

I. General information

NPI: 1265561476
Provider Name (Legal Business Name): UNM HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 01/08/2020
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 LOMAS BLVD NE
ALBUQUERQUE NM
87106-2745
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 505-272-2644
  • Fax: 505-272-1827
Mailing address:
  • Phone: 505-272-2521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number6005
License Number StateNM

VIII. Authorized Official

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