Provider Demographics
NPI:1922476415
Name:AMY LENROW
Entity Type:Organization
Organization Name:AMY LENROW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTR
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:LENROW
Authorized Official - Suffix:
Authorized Official - Credentials:MA OTR/L
Authorized Official - Phone:610-585-0325
Mailing Address - Street 1:1510 POWDER MILL LN
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-2615
Mailing Address - Country:US
Mailing Address - Phone:610-585-0325
Mailing Address - Fax:
Practice Address - Street 1:1510 POWDER MILL LANE
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096
Practice Address - Country:US
Practice Address - Phone:610-585-0325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC007074L314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility