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DSH320002P ST. VINCENT HOSPITAL (Terminated)
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Main Details
Name
ST. VINCENT HOSPITAL
Subdivision Name
NM Heart and Vascular Institute - Radiology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH320002P
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
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