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Organization
ST. VINCENT HOSPITAL
Active
Organization
ST. VINCENT HOSPITAL
Active
Other names
CHRISTUS St. Vincent DeVargas Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE TASSIN (PRESIDENT/CEO)
(505) 820-5201
Entity
Organization
Contact information
Practice address
510 N GUADALUPE ST, SUITE C1, SANTA FE, NM 87501-6510
(505) 913-4660
Mailing address
510 N GUADALUPE ST, SUITE C1, SANTA FE, NM 87501-6510
(505) 913-4660
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51038846
—
NM
Enumeration date
11/22/2010
Last updated
02/11/2014
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