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General NPI Number Information
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NPI Number | 1295004547
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Entity Type | Organization
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Legal Business Name | ST. VINCENT HOSPITAL
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Dates
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Enumeration Date | 12/15/2011
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Last Update Date | 03/13/2012
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Provider Practice Location Address
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Address Line | 2990 RODEO PARK DR E
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City | SANTA FE
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State | NM
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Zip | 87505-6302
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Country | US
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Telephone | 505-428-5400
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Fax | 505-428-5382
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Provider Business Mailing Address
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Address Line | 2990 RODEO PARK DR E
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City | SANTA FE
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State | NM
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Zip | 87505-6302
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Country | US
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Telephone | 505-428-5400
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Fax | 505-428-5382
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Authorized Official
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Title or Position | PRESIDENT & CHIEF EXECUTIVE OFFICER
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Name | JOSEPH ALEX VALDEZ
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Credential |
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Telephone | 505-913-5202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 6296
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License Number State | NM
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