Provider Demographics
NPI:1710013123
Name:EL PASO COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:EL PASO COUNTY HOSPITAL DISTRICT
Other - Org Name:UNIVERSITY MEDICAL CENTER YSLETA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JACOB
Authorized Official - Last Name:CINTRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-521-7602
Mailing Address - Street 1:PO BOX 202507
Mailing Address - Street 2:EL PASO COUNTY HOSPITAL DISTRICT
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-2507
Mailing Address - Country:US
Mailing Address - Phone:915-790-5722
Mailing Address - Fax:915-790-5721
Practice Address - Street 1:300 S ZARAGOZA RD BLDG B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907-6635
Practice Address - Country:US
Practice Address - Phone:915-790-5722
Practice Address - Fax:915-790-5721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX195403336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2092127OtherPK
TX251017Medicaid