Provider Demographics
NPI:1497028070
Name:LORMA MEDICAL CENTER
Entity Type:Organization
Organization Name:LORMA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD, BILLING DEPARTMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARICIEL
Authorized Official - Middle Name:MARQUEZ
Authorized Official - Last Name:CORTEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:630928-481-7194
Mailing Address - Street 1:CARLATAN
Mailing Address - Street 2:
Mailing Address - City:SAN FERNANDO CITY
Mailing Address - State:LA UNION
Mailing Address - Zip Code:2500
Mailing Address - Country:PH
Mailing Address - Phone:63072-888-2616
Mailing Address - Fax:63072-888-3417
Practice Address - Street 1:CARLATAN
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO CITY
Practice Address - State:LA UNION
Practice Address - Zip Code:2500
Practice Address - Country:PH
Practice Address - Phone:63072-888-2616
Practice Address - Fax:63072-888-3417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PHL0003125OtherNON-NETWORK CERTIFIED PROVIDER