Provider Demographics
NPI:1881154821
Name:DREW LEWIS FOUNDATION, INC.
Entity type:Organization
Organization Name:DREW LEWIS FOUNDATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANSIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-880-5001
Mailing Address - Street 1:1126 N BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-4158
Mailing Address - Country:US
Mailing Address - Phone:417-720-1890
Mailing Address - Fax:
Practice Address - Street 1:1126 N BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-4158
Practice Address - Country:US
Practice Address - Phone:417-720-1890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty