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General NPI Number Information
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NPI Number | 1508704040
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Entity Type | Organization
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Legal Business Name | BRISTOL HOSPICE - NEW MEXICO, LLC
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Dates
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Enumeration Date | 03/24/2026
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Last Update Date | 03/24/2026
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Provider Practice Location Address
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Address Line | 6001 INDIAN SCHOOL RD NE STE 160
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-4183
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Country | US
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Telephone | 505-337-0520
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Fax | 505-717-7633
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Provider Business Mailing Address
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Address Line | 206 N 2100 W STE 202
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City | SALT LAKE CITY
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State | UT
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Zip | 84116-4741
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | ALEX MAURICIO
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Credential |
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Telephone | 801-325-0175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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