Healthcare Provider Details

I. General information

NPI: 1528193190
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

2600 YALE BLVD SE STE 2220
ALBUQUERQUE NM
87106-4383
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 505-272-6700
  • Fax: 505-272-6735
Mailing address:
  • Phone: 505-272-4275
  • Fax: 505-272-9991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number6005
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number6133
License Number StateNM

VIII. Authorized Official

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