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DSH320005 SAN JUAN REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
SAN JUAN REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH320005
Medicare Provider Number
320005
Additional Details
Current Program Status
Active
Registration Date
8/25/2008
Participating Start Date
9/1/2008
Participating Approval Date
8/26/2008
Last Recertification Date
8/18/2024
Contacts
Authorizing Official
San Juan Regional Medical Center
Olena Erickson, Associate Chief Financial Officer (ACFO)
(505) 609-6238
Primary Contact
San Juan Regional Medical Center
Aaron Buffington, Director of Pharmacy
(505) 609-2484
Addresses
Street Address
801 W. MAPLE
FARMINGTON, NM 87401
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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