Directory information — verify before you send. This fax number was compiled by automated research from public sources. It may be out of date, incomplete, incorrect, or in rare cases wrong entirely, and it is not confirmed by Mesilla Valley Hospital. Before sending anything sensitive, confirm the number and receiving department directly with Mesilla Valley Hospital, and consider sending a test cover page first. FaxFlow is an independent directory, is not affiliated with, endorsed by, or sponsored by this organization, and accepts no liability for reliance on this listing.
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Mesilla Valley Hospital fax number
(575) 382-4904
Wrong or outdated? Report this number
Medical Records Department
Used for: Medical records release / disclosure authorization (Authorization for Disclosure, Use or Receipt of Protected Health Information)
Fax destination details
- Department
- Medical Records Department
- Purpose
- Medical records release / disclosure authorization (Authorization for Disclosure, Use or Receipt of Protected Health Information)
- Form
- ROI Form 1504 — Authorization for Disclosure, Use or Receipt of Protected Health Information
- Address
- 3751 Del Rey Blvd, Las Cruces, NM 88012
- Voice phone
- (575) 382-3500
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Fill in all fields, sign and date the form, and include your phone number. Provide patient or authorized representative details, designate the recipient (e.g., Medical Records), and fax the completed form to 575-382-4904 or mail to Mesilla Valley Hospital, 3751 Del Rey Blvd, Las Cruces, NM 88012. The form expires 180 days after signing.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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