Healthcare Provider Details

I. General information

NPI: 1669536603
Provider Name (Legal Business Name): UNM HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 01/08/2020
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1127 UNIVERSITY BLVD NE
ALBUQUERQUE NM
87102-1740
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 505-272-5200
  • Fax: 505-272-3215
Mailing address:
  • Phone: 505-272-2521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number6074
License Number StateNM

VIII. Authorized Official

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