| Ltc Aco Participant 101, PC | |
|
1700 Pine St Norristown PA 19401-3040 | |
| (610) 237-7100 | |
| (610) 277-6239 |
| Full Name | Ltc Aco Participant 101, PC |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 1700 Pine St, Norristown, Pennsylvania |
| Authorized Official Name and Position | Brittain Brantley (ACTING PRESIDENT) |
| Authorized Official Contact | 3023005138 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ltc Aco Participant 101, PC Po Box 639676 Cincinnati OH 45263-9676 | Ltc Aco Participant 101, PC 1700 Pine St Norristown PA 19401-3040 Ph: (610) 237-7100 |
| NPI Number | 1689524712 |
|---|---|
| Provider Enumeration Date | 01/29/2026 |
| Last Update Date | 08/13/2026 |
| Certification Date | 08/13/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689524712 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (NU) | Primary |
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