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DSH320089 UNM SANDOVAL REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
UNM SANDOVAL REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH320089
Medicare Provider Number
320089
Additional Details
Current Program Status
Terminated
Registration Date
1/8/2016
Participating Start Date
4/1/2016
Participating Approval Date
3/11/2016
Last Recertification Date
8/17/2023
Termination Date
Termination Reason
4/1/2024
Other
Contacts
Authorizing Official
UNM Sandoval Regional Medical Center
Jamie Silva-Steele, President and CEO
(505) 994-7430
Primary Contact
UNM Sandoval Regional Medical Center
Rowena Castillo, 340B coordinator
(505) 994-7050
Addresses
Street Address
3001 BROADMOOR BLVD NE
RIO RANCHO, NM 87144
Billing Address
UNM Sandoval Regional Medical Center
PO Box 80600
Albuquerque, NM 87198
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/11/16 Participating 4/1/2015 until terminated effective 10/1/2015, reinstated effective 4/1/2016
03/11/2016
May 2025
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