Provider Demographics
NPI:1669850707
Name:UNIVERSITY OF NEW MEXICO HOSPITAL
Entity Type:Organization
Organization Name:UNIVERSITY OF NEW MEXICO HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KYMBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-272-6225
Mailing Address - Street 1:1963 S 1200 E
Mailing Address - Street 2:401
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-3510
Mailing Address - Country:US
Mailing Address - Phone:801-906-3238
Mailing Address - Fax:
Practice Address - Street 1:1963 S 1200 E
Practice Address - Street 2:401
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-3510
Practice Address - Country:US
Practice Address - Phone:801-906-3238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty