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General NPI Number Information
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NPI Number | 1780534818
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Entity Type | Organization
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Legal Business Name | LTC ACO PARTICIPANT 107, PC
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 1700 PINE ST
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City | NORRISTOWN
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State | PA
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Zip | 19401-3040
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Country | US
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Telephone | 610-237-7100
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Fax | 610-277-6239
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Provider Business Mailing Address
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Address Line | PO BOX 639676
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City | CINCINNATI
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State | OH
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Zip | 45263-9676
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Country | US
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Telephone | 859-291-4800
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Fax |
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Authorized Official
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Title or Position | DIR. OF CRED / AUTHORIZED OFFICIAL
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Name | JILL C FORD
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Credential |
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Telephone | 859-291-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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