Organization
NEW MEXICO HEART INSTITUTE, LLC
Active
Parent organization
LOVELACE HEALTH SYSTEMS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOVELACE HEALTH SYSTEMS LLC
Authorized official
STEPHEN PETROVICH (EVP, GENERAL COUNSEL)
(615) 296-3594
Entity
Organization
Contact information
Practice address
502 ELM ST. NE, ALBUQUERQUE, NM 87102
(505) 841-1000
(505) 843-2956
Mailing address
502 ELM ST NE, ALBUQUERQUE, NM 87102-2512
(505) 841-1000
(505) 843-2956
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
FA0003020
NM
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
FA0003020
NM
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FA0003020 PT0002833
NMHI BUSINESS REGISTRATIO
NM
05
—
H5743
—
NM
Enumeration date
06/01/2005
Last updated
07/24/2019
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