Organization Name: | ST. VINCENT HOSPITAL |
NPI Number: | 1144627332 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRUCE TASSIN (CEO/PRESIDENT) |
Mailing Address: | 440 Saint Michaels Dr Csv Medical Group Santa Fe |
State: | NM US |
Postal Code: | 875057602 |
Phone Number: | 5059135227 |
Fax Number: | |
NPI Enumeration Date: | 12/03/2014 |
NPI Last Update Date: | 01/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |