Organization
HORIZON MEDICAL CORPORATION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA WRIGHT (CREDENTIALING)
(570) 876-1735
Entity
Organization
Contact information
Practice address
1721 N MAIN AVE, SCRANTON, PA 18508-1995
(570) 961-9947
(570) 341-5043
Mailing address
4 KELLY ST STE 4, ARCHBALD, PA 18403-1627
(570) 876-1735
(570) 876-1813
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017929090002
—
PA
01
—
40158
BLUE SHIELD GROUP NUMBER
PA
01
—
809779
FIRST PRIORITY HEALTH GRO
PA
Enumeration date
06/22/2006
Last updated
07/27/2020
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