Provider Demographics
NPI:1366208076
Name:LANCASTER NUTRITION AND WELLNESS LLC
Entity type:Organization
Organization Name:LANCASTER NUTRITION AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RD
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANCASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-737-6408
Mailing Address - Street 1:2206 HIGHLAND FOREST DR
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-7366
Mailing Address - Country:US
Mailing Address - Phone:704-737-6408
Mailing Address - Fax:
Practice Address - Street 1:2206 HIGHLAND FOREST DR
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-7366
Practice Address - Country:US
Practice Address - Phone:704-737-6408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty