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1962482257

NPI Code Detail

MEDICARE: FORNANCE PHYSICIAN SERVICES, INC.

MEDICARE: FORNANCE PHYSICIAN SERVICES, 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician
2	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician
3	207ZC0500X	Cytopathology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	444943	OTHER	PA	HIGHMARK BLUE SHIELD
3	47046	OTHER	PA	KEYSTONE MERCY
4	622047	OTHER	PA	TRIGON BLUE SHIELD
5	0048037000	OTHER	PA	AMERICHOICE/INTERCOUNTY
6	0048037000	OTHER	PA	IBC - PC, KHPE
7	G0001885	OTHER	PA	AMERICHOICE
8	2032281	OTHER	PA	AETNA
9	08723	OTHER	PA	HEALTH PARTNERS

General Provider Information

NPI Number	:	1962482257
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORNANCE PHYSICIAN SERVICES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 789967
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19178-9967
Country	:	US
Telephone Number	:	484-622-7395
Fax Number	:	484-622-7399

Provider Business Practice Location Address
First Line	:	559 W GERMANTOWN PIKE
Second Line	:
City	:	EAST NORRITON
State	:	PA
Zip	:	19403-4250
Country	:	US
Telephone Number	:	484-622-1435
Fax Number	:

Authorized Official
Title or Position	:	BILLING DIRECTOR
Name	:	VERA BURNETT-ROBINS
Credential	:
Telephone Number	:	484-622-7391

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	11/14/2018

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Directions to “FORNANCE PHYSICIAN SERVICES, INC. ” Practice Location

Language	Start Address	Practice Location

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