Healthcare Provider Details
I. General information
NPI: 1457618852
Provider Name (Legal Business Name): ST. VINCENT HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/23/2012
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
490 W ZIA RD # 100
SANTA FE NM
87505-6996
US
IV. Provider business mailing address
455 SAINT MICHAELS DR
SANTA FE NM
87505-7601
US
V. Phone/Fax
- Phone: 505-913-3450
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HOPE
WADE
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 505-913-5201