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DSH320001BK UNIVERSITY OF NEW MEXICO HOSPITAL (Terminated)
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Main Details
Name
UNIVERSITY OF NEW MEXICO HOSPITAL
Subdivision Name
Ortho Oncology / Medical Oncology Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH320001BK
Medicare Provider Number
320001
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/10/2015
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
1201 Camino De Salud
Third Floor
Albuquerque, NM 87102
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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