MEDICARE: INTOUCH MEDICALASSOCIATES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	OS005361L	PA

General Provider Information

NPI Number	:	1639148448
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTOUCH MEDICALASSOCIATES INC.

Provider Business Mailing Address
First Line	:	2109 W DIAMOND ST
Second Line	:	N/A
City	:	PHILADELPHIA
State	:	PA
Zip	:	19121-1434
Country	:	US
Telephone Number	:	215-236-1131
Fax Number	:	215-232-3680

Provider Business Practice Location Address
First Line	:	2109 W DIAMOND ST
Second Line	:	N/A
City	:	PHILADELPHIA
State	:	PA
Zip	:	19121-1434
Country	:	US
Telephone Number	:	215-236-1131
Fax Number	:	215-232-3680

Authorized Official
Title or Position	:	PRESIDENT /OWNER
Name	:	DR. BRUCE WILLIAMS SR.
Credential	:	DO.
Telephone Number	:	215-236-1131

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	09/18/2008

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