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DSH320002Q ST. VINCENT HOSPITAL (Terminated)
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Main Details
Name
ST. VINCENT HOSPITAL
Subdivision Name
NM Heart and Vascular Institute - Cardiology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH320002Q
Medicare Provider Number
320002
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/14/2014
Participating Start Date
7/1/2014
Participating Approval Date
6/11/2014
Last Recertification Date
8/14/2015
Termination Date
Termination Reason
10/1/2015
Site closure
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
2085 S. Pacheco St.
SANTA FE, NM 87505
Billing Address
CHRISTUS St. Vincent Hospital
455 St. Michaels Drive
Santa Fe, NM 87505
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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