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1427058510

NPI Code Detail

MEDICARE: SAN JUAN REGIONAL MEDICAL CENTER, INC.

MEDICARE: SAN JUAN REGIONAL MEDICAL CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	6291	NM
2	341600000X	Ambulance	6291	NM
3	3416A0800X	Air Ambulance	6291	NM
4	3416L0300X	Land Ambulance	6291	NM
5	282N00000X	General Acute Care Hospital	6291	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427058510
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAN JUAN REGIONAL MEDICAL CENTER, INC.

Provider Business Mailing Address
First Line	:	801 WEST MAPLE STREET
Second Line	:
City	:	FARMINGTON
State	:	NM
Zip	:	87401-5630
Country	:	US
Telephone Number	:	505-325-5011
Fax Number	:	505-609-6249

Provider Business Practice Location Address
First Line	:	801 W MAPLE ST
Second Line	:
City	:	FARMINGTON
State	:	NM
Zip	:	87401-5630
Country	:	US
Telephone Number	:	505-325-5011
Fax Number	:	505-609-6249

Authorized Official
Title or Position	:	CFO
Name	:	MR. JOHN MAYER
Credential	:
Telephone Number	:	505-609-2000

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	07/09/2025

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Directions to “SAN JUAN REGIONAL MEDICAL CENTER, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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