UNM HOSPITAL

Provider Demographics

• NPI: 1689747552
• Name: UNM HOSPITAL
• Entity Type: Organization
• Organization Name: UNM HOSPITAL
• Authorized Official - Title/Position: CHIEF FINANCIAL OFFICER
• Authorized Official - First Name: BONNIE
• Authorized Official - Middle Name: MARIE
• Authorized Official - Last Name: WHITE
• Authorized Official - Phone: 505-272-1840
• Mailing Address - Street 1: 400 TIJERAS AVE NW STE 450
• Mailing Address - City: ALBUQUERQUE
• Mailing Address - State: NM
• Mailing Address - Zip Code: 87102-3273
• Mailing Address - Country: US
• Mailing Address - Phone: 505-272-4275
• Mailing Address - Fax: 505-272-9991
• Practice Address - Street 1: 2211 LOMAS BLVD., N.E.
• Practice Address - City: ALBUQUERQUE
• Practice Address - State: NM
• Practice Address - Zip Code: 87106-2719
• Practice Address - Country: US
• Practice Address - Phone: 505-272-1221
• Practice Address - Fax: 505-272-1827
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-11-16
• Last Update Date: 2020-01-08

Provider Licenses

State	License ID	Taxonomies
		103TC0700X, 363A00000X, 363LA2100X, 364SA2100X, 364SP0808X
NM	6005	225000000X, 251J00000X, 251K00000X, 273R00000X, 282N00000X, 332B00000X, 335E00000X, 3416A0800X
NM	NM-10004-M	261QM2800X
NM		273R00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	282N00000X	Hospitals	General Acute Care Hospital
No	103TC0700X	Behavioral Health & Social Service Providers	Psychologist	Clinical	Group - Multi-Specialty
No	225000000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Orthotic Fitter		Group - Multi-Specialty
No	251J00000X	Agencies	Nursing Care		Group - Multi-Specialty
No	251K00000X	Agencies	Public Health or Welfare
No	261QM2800X	Ambulatory Health Care Facilities	Clinic/Center	Methadone
No	273R00000X	Hospital Units	Psychiatric Unit		Group - Multi-Specialty
No	332B00000X	Suppliers	Durable Medical Equipment & Medical Supplies
No	335E00000X	Suppliers	Prosthetic/Orthotic Supplier		Group - Multi-Specialty
No	3416A0800X	Transportation Services	Ambulance	Air Transport	Group - Multi-Specialty
No	363A00000X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant		Group - Multi-Specialty
No	363LA2100X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Acute Care	Group - Multi-Specialty
No	364SA2100X	Physician Assistants & Advanced Practice Nursing Providers	Clinical Nurse Specialist	Acute Care	Group - Multi-Specialty
No	364SP0808X	Physician Assistants & Advanced Practice Nursing Providers	Clinical Nurse Specialist	Psychiatric/Mental Health	Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
NM	00000067	Medicaid
NM	0003	Other	CHAMPUS
NM	24409065	Medicaid
NM	T2313	Medicaid
NM	28350839	Medicaid
NM	02156901	Other	AHCCCS
NM	00000092	Medicaid
NM	NM00006	Other	BCBS
NM	60054	Other	AETNA
NM	62308	Other	CIGNA
NM	201080119	Other	PRESBYTERIAN SALUD
NM	450	Other	LOVELACE SALUD
NM	03709779	Medicaid
NM	T2313	Medicaid
NM	00000067	Medicaid
	320001	Medicare Oscar/Certification
NM	02156901	Other	AHCCCS