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SAMANTHA LYNN LENZENDORF
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1386273159
Individual Registrant: SAMANTHA LYNN LENZENDORF
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
N7121 NEWVILLE RD WATERLOO, WI 53594-9534 US
Tel: 847-778-6529 Fax: --
Tel: 847-778-6529 Fax: --
Contact information for business:
N7121 NEWVILLE RD WATERLOO, WI 53594-9534 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1386273159
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | WI | 18616-40 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| WALGREENS | 361924025 | WI | 01 |
