Healthcare Provider Details

I. General information

NPI: 1992461255
Provider Name (Legal Business Name): ST. VINCENT HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2021
Last Update Date: 11/11/2021
Certification Date: 10/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1631 HOSPITAL DR STE 112
SANTA FE NM
87505-4728
US

IV. Provider business mailing address

455 SAINT MICHAELS DR
SANTA FE NM
87505-7601
US

V. Phone/Fax

Practice location:
  • Phone: 505-913-4780
  • Fax: 505-913-6780
Mailing address:
  • Phone: 505-913-5227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: REUBEN MURRAY
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 505-913-5271