1689747552 NPI number — UNM HOSPITAL

Table of content: (NPI 1689747552)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689747552 NPI number — UNM HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNM HOSPITAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689747552
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/08/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 TIJERAS AVE NW STE 450
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALBUQUERQUE
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87102-3273
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-272-4275
Provider Business Mailing Address Fax Number:
505-272-9991

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2211 LOMAS BLVD., N.E.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87106-2719
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-272-1221
Provider Business Practice Location Address Fax Number:
505-272-1827
Provider Enumeration Date:
11/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WHITE
Authorized Official First Name:
BONNIE
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
505-272-1840

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225000000X , with the licence number: 6005 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251J00000X , with the licence number: 6005 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251K00000X , with the licence number: 6005 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM2800X , with the licence number: NM-10004-M , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 273R00000X , with the licence number: 6005 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 273R00000X , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: 6005 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X , with the licence number: 6005 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X , with the licence number: 6005 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416A0800X , with the licence number: 6005 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 364SA2100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 364SP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00000067 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0003 . This is a "CHAMPUS" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 24409065 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: T2313 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 28350839 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02156901 . This is a "AHCCCS" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 00000092 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: NM00006 . This is a "BCBS" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 60054 . This is a "AETNA" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 62308 . This is a "CIGNA" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 201080119 . This is a "PRESBYTERIAN SALUD" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 450 . This is a "LOVELACE SALUD" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 03709779 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".




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