Provider Demographics
NPI:1407076268
Name:CENTRAL PENN NURSING CARE INC
Entity Type:Organization
Organization Name:CENTRAL PENN NURSING CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:H
Authorized Official - Last Name:STRAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-569-0451
Mailing Address - Street 1:1910 FRUITVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-3997
Mailing Address - Country:US
Mailing Address - Phone:717-569-0451
Mailing Address - Fax:717-569-4528
Practice Address - Street 1:1910 FRUITVILLE PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3997
Practice Address - Country:US
Practice Address - Phone:717-569-0451
Practice Address - Fax:717-569-4528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Single Specialty
No163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty
No163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Single Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitationGroup - Single Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019039460001OtherPDA WAIVER
PA0019039460003OtherMHMR