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DSH320001BD UNIVERSITY OF NEW MEXICO HOSPITAL (Terminated)
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Main Details
Name
UNIVERSITY OF NEW MEXICO HOSPITAL
Subdivision Name
UNM HOSPITAL / ASAP O/P Medical Services
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH320001BD
Medicare Provider Number
320001
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/15/2014
Participating Start Date
1/1/2015
Participating Approval Date
10/29/2014
Last Recertification Date
9/10/2021
Termination Date
Termination Reason
4/1/2022
Business decision by the Covered Entity
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 AVE NE
UNMH ASAP CLINIC
ALBUQUERQUE, NM 87106-2058
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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April 2025
April 2025
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