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DSH320001AA UNIVERSITY OF NEW MEXICO HOSPITAL (Terminated)
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Main Details
Name
UNIVERSITY OF NEW MEXICO HOSPITAL
Subdivision Name
UNM HOSPITAL PSYCHIATRIC CENTER UPC Development Disability
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH320001AA
Medicare Provider Number
320001
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
12/16/2009
Participating Start Date
1/1/2010
Participating Approval Date
12/21/2009
Last Recertification Date
9/4/2018
Termination Date
Termination Reason
7/1/2019
Site closure
Contacts
Authorizing Official
UNM Hospitals
Bonnie White, Chief Financial Officer
(505) 272-1840
Primary Contact
UNM Hospital
Louis E Achusim, Executive Director of Pharmacy
(505) 272-2038
Addresses
Street Address
2600 MARBLE NE
Second Floor
ALBUQUERQUE, NM 87106
Billing Address
University of New Mexico Hospital
PO Box 80600
Albuquerque, NM 87198-0600
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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