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DSH320002U ST. VINCENT HOSPITAL (Active)
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Main Details
Name
ST. VINCENT HOSPITAL
Subdivision Name
CHRISTUS St. Vincent Heart & Vascular Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH320002U
Medicare Provider Number
320002
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/7/2017
Participating Start Date
10/1/2017
Participating Approval Date
8/8/2017
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
St. Vincent Hospital
Lillian Montoya, President and CEO
(505) 913-5258
Primary Contact
St. Vincent Hospital
Christine Atwell, Director of Pharmacy
(505) 913-5522
Addresses
Street Address
1631 Hospital Drive
Suite 110
SANTA FE, NM 87505
Billing Address
St. Vincent Hospital
455 St. Michaels Drive
Santa Fe, NM 87505
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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