Provider Demographics
NPI:1639479520
Name:UNIVERSITY OF NEW MEXICO HOSPITALS ASAP
Entity type:Organization
Organization Name:UNIVERSITY OF NEW MEXICO HOSPITALS ASAP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKERNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-272-2070
Mailing Address - Street 1:2450 ALAMO AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-3204
Mailing Address - Country:US
Mailing Address - Phone:505-925-2400
Mailing Address - Fax:505-925-2411
Practice Address - Street 1:2450 ALAMO AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-3204
Practice Address - Country:US
Practice Address - Phone:505-925-2400
Practice Address - Fax:505-925-2411
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF NEW MEXICO HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NML17349261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone