Organization
ST VINCENT HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. J ALEX VALDEZ (CEO)
(505) 983-3361
Entity
Organization
Contact information
Practice address
5 PETROGLYPH CIRCLE, SUITE A, POJOAQUE, NM 87506
(505) 983-3361
Mailing address
455 SAINT MICHAELS DR, MEDICAL STAFF OFFICE, SANTA FE, NM 87505-7601
(505) 820-5227
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
MD2007-0167
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10034175
CIGNA/LOVELACE
—
01
—
2393470
UHC
—
05
—
64680541
—
NM
01
—
NM002Q05
BCBS NM
NM
01
—
QMP000003399099
MOLINA
—
Enumeration date
05/07/2007
Last updated
01/07/2008
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