# SAN JUAN REGIONAL MEDICAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SAN JUAN REGIONAL MEDICAL CENTER INC
- **Other names:** SAN JUAN REGIONAL MIDWIFERY & WOMENS HEALTH CENTER, SJHP OB & GYN 634, SJHP OB & GYN 610
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1124262415
- **Legal business name:** SAN JUAN REGIONAL MEDICAL CENTER INC
- **Authorized official:** KIM BYRD (ADMINISTRATIVE DIRECTOR OF REIMBURS)
- **Authorized official phone:** (505) 609-2258

## Contact information

- **Practice address:** 655 W PINON ST, FARMINGTON, NM 87401-5973
- **Practice address phone:** (505) 609-2590
- **Practice address fax:** (505) 609-2595
- **Mailing address:** PO BOX 844088, DALLAS, TX 75284-4088
- **Mailing address phone:** (505) 609-2258
- **Mailing address fax:** (505) 609-2259

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 363LX0001X | Obstetrics & Gynecology Nurse Practitioner | — | NULL | — |
| 363LX0001X | Obstetrics & Gynecology Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 04/30/2009
- **Last updated:** 07/16/2025