Healthcare Provider Details

I. General information

NPI: 1174956767
Provider Name (Legal Business Name): LOVELACE HEALTH SYSTEM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2013
Last Update Date: 05/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 E 19TH ST
ROSWELL NM
88201-5151
US

IV. Provider business mailing address

1 BURTON HILLS BLVD SUITE 250
NASHVILLE TN
37215-6293
US

V. Phone/Fax

Practice location:
  • Phone: 575-627-7000
  • Fax: 575-625-3309
Mailing address:
  • Phone: 615-296-3000
  • Fax: 615-296-6011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateNM

VIII. Authorized Official

Name: STEPHEN C PETROVICH
Title or Position: SVP
Credential:
Phone: 615-296-3000