Healthcare Provider Details

I. General information

NPI: 1528585049
Provider Name (Legal Business Name): ST VINCENT HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1631 HOSPITAL DR
SANTA FE NM
87505-4728
US

IV. Provider business mailing address

1631 HOSPITAL DR
SANTA FE NM
87505-4728
US

V. Phone/Fax

Practice location:
  • Phone: 505-982-7246
  • Fax: 505-983-4812
Mailing address:
  • Phone: 505-982-7246
  • Fax: 505-983-4812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number StateNM

VIII. Authorized Official

Name: PATRICK CARRIER
Title or Position: PRESIDENT/CEO
Credential:
Phone: 505-913-5201