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DSH320002X ST. VINCENT HOSPITAL (Active)
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Main Details
Name
ST. VINCENT HOSPITAL
Subdivision Name
CHRISTUS ST VINCENT PAIN & SPINE SP - Pain and Spine
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH320002X
Medicare Provider Number
320002
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/11/2023
Participating Start Date
10/1/2023
Participating Approval Date
8/24/2023
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
2990 Rodeo Park Dr. E
Santa Fe, NM 87505-7631
Billing Address
CHRISTUS St. Vincent Hospital
455 St. Michaels Drive
Santa Fe, NM 87505
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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