San Juan Regional Medical Center INC
Internal Medicine, Cardiovascular Disease in Farmington, NM. Organization (NPI-2).
NPI number1033327770
StatusActive
Last updated in NPPESJul 16, 2025
Details
- NPI
- 1033327770
- Entity type
- Organization (NPI-2)
- Legal business name
- San Juan Regional Medical Center INC
- Organization subpart
- No
- Enumeration date
- May 18, 2007
- Certification date
- Jul 16, 2025
- Last updated
- Jul 16, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RC0000X | Internal Medicine, Cardiovascular Disease | – | – | Yes |
| 207RP1001X | Internal Medicine, Pulmonary Disease | – | – | |
| 208800000X | Urology | – | – |
Other names
- San Juan Regional Heart Center (Doing Business As)
- San Juan Regional Cardiology (Doing Business As)
Practice location
407 S Schwartz AveSuite 202
Farmington, NM 87401
Phone 505-609-6770 · Fax 505-609-6775
Mailing address
Po Box 844088Dallas, TX 75284-4088
Phone 505-609-2258 · Fax 505-609-2259
Other practice locations
480 Wolverine Dr Ste 12
Bayfield, CO 81122-9653
Bayfield, CO 81122-9653
Phone 970-444-0260
Authorized official
Kim Byrd
Administrative Director Of Reimburs
5056092258
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