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DSH320002AB ST. VINCENT HOSPITAL (Active)
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Main Details
Name
ST. VINCENT HOSPITAL
Subdivision Name
NM Heart - Cardiology Services
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH320002AB
Medicare Provider Number
320002
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/8/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/9/2024
Last Recertification Date
Contacts
Authorizing Official
St. Vincent Hospital
Lillian Montoya, President and CEO
(505) 913-5258
Primary Contact
St. Vincent Hospital
Christine Atwell, Director of Pharmacy
(505) 913-5522
Addresses
Street Address
2237 Trinity Dr.
Unit D-2
Los Alamos, NM 87544
Billing Address
ST. VINCENT HOSPITAL
455 ST. MICHAELS DRIVE
SANTA FE, NM 87505
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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