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DSH320001AZ UNIVERSITY OF NEW MEXICO HOSPITAL (Terminated)
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Main Details
Name
UNIVERSITY OF NEW MEXICO HOSPITAL
Subdivision Name
UNM HOSPITAL / CTH Transitions Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH320001AZ
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
11/29/2017
Termination Date
Termination Reason
7/1/2018
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
1127 UNIVERSITY BLVD., N.E.
UNMH CARRIE TINGLEY CLINICS
ALBUQUERQUE, NM 87102-1740
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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