Provider Demographics
NPI:1770794778
Name:FIRST HORIZON MEDICAL CENTER PA
Entity type:Organization
Organization Name:FIRST HORIZON MEDICAL CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:I
Authorized Official - Last Name:DEL MORAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-497-1302
Mailing Address - Street 1:PO BOX 13230
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79913-3230
Mailing Address - Country:US
Mailing Address - Phone:915-497-1302
Mailing Address - Fax:
Practice Address - Street 1:14476 HORIZON BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:HORIZON CITY
Practice Address - State:TX
Practice Address - Zip Code:79928-8578
Practice Address - Country:US
Practice Address - Phone:915-497-1302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty