Provider Demographics
NPI:1801134325
Name:UNM HOSPITAL
Entity type:Organization
Organization Name:UNM HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF RN
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNAL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:505-272-2800
Mailing Address - Street 1:9425 ALLANDE RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-6617
Mailing Address - Country:US
Mailing Address - Phone:505-857-9517
Mailing Address - Fax:
Practice Address - Street 1:9425 ALLANDE RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-6617
Practice Address - Country:US
Practice Address - Phone:505-857-9517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITH OF NEW MEXICO HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR16251283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital