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DSH320001CG UNIVERSITY OF NEW MEXICO HOSPITAL (Active)
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Main Details
Name
UNIVERSITY OF NEW MEXICO HOSPITAL
Subdivision Name
Radiology - Diagnostic / Outpatient Surgical & Imaging Services- Mammography
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH320001CG
Medicare Provider Number
320001
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/17/2017
Participating Start Date
4/1/2017
Participating Approval Date
3/11/2017
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
UNM Hospitals
Bonnie White, Chief Financial Officer
(505) 272-1840
Primary Contact
University of New Mexico Hospital
Lorena Vigil, Ambulatory Business Operations Mgr - 340B Program
(505) 272-2134
Addresses
Street Address
1213 University Blvd NE
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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