1902931652 NPI number — UNM HOSPITAL

Table of content: (NPI 1902931652)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902931652 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:
UNIVERSITY PSYCHIATRIC CTR-OP
Provider Other Organization Name Type Code:
3
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:
1902931652
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:
PO BOX 369
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:
87103-0369
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-272-2521
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2600 MARBLE AVE NE
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:
87106-2058
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-272-2861
Provider Business Practice Location Address Fax Number:
505-272-2016
Provider Enumeration Date:
02/22/2007

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: 282N00000X , with the licence number:  6005 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 201080119 . This is a "PRESBYTERIAN SALUD" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 00092 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • 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: 29966 . This is a "PRESBYTERIAN HEALTH PLAN" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: PROVFP9547 . This is a "CIMARRON SALUD" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 0003 . This is a "CHAMPUS" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 02156901 . This is a "AHCCCS" 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: 62310 . This is a "LOVELACE HEALTH PLAN" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: NM000006 . This is a "BCBS" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".




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