MEDICARE: WORDSWORTH ACADEMY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)		PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407806433
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WORDSWORTH ACADEMY

Provider Business Mailing Address
First Line	:	2101 PENNSYLVANIA AVE
Second Line	:
City	:	FT WASHINGTON
State	:	PA
Zip	:	19034-2912
Country	:	US
Telephone Number	:	215-643-5400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 PENNSYLVANIA AVE
Second Line	:
City	:	FT WASHINGTON
State	:	PA
Zip	:	19034-2912
Country	:	US
Telephone Number	:	215-643-5400
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	DEBRA LACKS
Credential	:
Telephone Number	:	215-643-5400

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	02/08/2013

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Directions to “WORDSWORTH ACADEMY ” Practice Location

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