Provider Demographics
NPI:1639148448
Name:INTOUCH MEDICALASSOCIATES INC.
Entity type:Organization
Organization Name:INTOUCH MEDICALASSOCIATES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT /OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:SR
Authorized Official - Credentials:DO
Authorized Official - Phone:215-236-1131
Mailing Address - Street 1:2109 W DIAMOND ST
Mailing Address - Street 2:N/A
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19121-1434
Mailing Address - Country:US
Mailing Address - Phone:215-236-1131
Mailing Address - Fax:215-232-3680
Practice Address - Street 1:2109 W DIAMOND ST
Practice Address - Street 2:N/A
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19121-1434
Practice Address - Country:US
Practice Address - Phone:215-236-1131
Practice Address - Fax:215-232-3680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005361L261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC29860Medicare UPIN