Healthcare Provider Details

I. General information

NPI: 1619002300
Provider Name (Legal Business Name): UNM HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 01/08/2020
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 YALE BLVD NE
ALBUQUERQUE NM
87106-3825
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 505-272-2210
  • Fax: 505-272-0052
Mailing address:
  • Phone: 505-272-2521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number6005
License Number StateNM

VIII. Authorized Official

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