Provider Demographics
NPI:1366412967
Name:FORNANCE PHYSICIAN SERVICES, INC.
Entity type:Organization
Organization Name:FORNANCE PHYSICIAN SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REIMBURSEMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWE-ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-622-7382
Mailing Address - Street 1:PO BOX 8500-9967
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-9967
Mailing Address - Country:US
Mailing Address - Phone:484-622-7395
Mailing Address - Fax:484-622-7399
Practice Address - Street 1:1330 POWELL ST
Practice Address - Street 2:SUITE 504
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3353
Practice Address - Country:US
Practice Address - Phone:610-277-2635
Practice Address - Fax:610-270-2786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA33408OtherKEYSTONE MERCY
PA0084467000OtherIBC - PC, KHPE
PA151652OtherHIGHMARK BLUE SHIELD
PA5170305OtherAETNA PPO
PA0084467000OtherAMERIHEALTH/INTERCOUNTY
PA210 2369OtherAETNA HMO
PA16513OtherHEALTH PARTNERS
PA=========OtherMULTIPLAN
PA=========OtherUNHC
PA0084467000OtherIBC - PC, KHPE
PA33408OtherKEYSTONE MERCY
PA=========OtherAMERICARE/DEVON