Healthcare Provider Details
I. General information
NPI: 1134165681
Provider Name (Legal Business Name): UNM HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/22/2006
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1209 UNIVERSITY BLVD NE
ALBUQUERQUE NM
87102-1727
US
IV. Provider business mailing address
1209 UNIVERSITY BLVD NE
ALBUQUERQUE NM
87102-1727
US
V. Phone/Fax
- Phone: 505-272-2309
- Fax: 505-272-8882
- Phone: 505-272-2309
- Fax: 505-272-8882
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336M0003X |
| Taxonomy | Managed Care Organization Pharmacy |
| License Number | PH00001837 |
| License Number State | NM |
VIII. Authorized Official
Name:
FRIEDA
ORTEGA
Title or Position: DIRECTOR OF PHARMACY
Credential: RPH PHARM D
Phone: 505-272-0526