# NMVAHCS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386673531
- **Authorized official:** MARY CATHLEEN GUILLEN R.D. (RENAL DIETITIAN)
- **Authorized official phone:** (505) 265-1711

## Contact information

- **Practice address:** 1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
- **Practice address phone:** (505) 265-1711
- **Mailing address:** 1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 379 | NM | Yes |

## Other

- **Enumeration date:** 07/01/2006
- **Last updated:** 08/22/2020