Provider Demographics
NPI:1750351342
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:610-270-2352
Mailing Address - Street 1:PO BOX 820137
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0137
Mailing Address - Country:US
Mailing Address - Phone:610-270-2352
Mailing Address - Fax:610-270-2358
Practice Address - Street 1:1301 POWELL ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3323
Practice Address - Country:US
Practice Address - Phone:610-270-2771
Practice Address - Fax:610-270-2772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Not Answered2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1770604OtherHIGHMARK BLUE SHIELD
PA2453154000OtherIBC - PC, KHPE
PA2453154000OtherAMERIHEALTH/INTERCOUNTY
PA=========OtherPHCS
PA2453154000OtherIBC - PC, KHPE
PA=========OtherUNHC
PA=========OtherAMERICARE/DEVON
PA=========OtherMULTIPLAN