Provider Demographics
NPI:1538799358
Name:SCIPHER MEDICINE CORPORATION
Entity type:Organization
Organization Name:SCIPHER MEDICINE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:SEETO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-724-7437
Mailing Address - Street 1:PO BOX 412849
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-2849
Mailing Address - Country:US
Mailing Address - Phone:855-724-7437
Mailing Address - Fax:833-643-1004
Practice Address - Street 1:8 DAVIS DR, #2A
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27709
Practice Address - Country:US
Practice Address - Phone:855-724-7437
Practice Address - Fax:833-643-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-21
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100764590Medicaid
MI1538799358Medicaid
LA3944901Medicaid
GA003277280AMedicaid
AZ092275Medicaid
NC1538799358Medicaid
CO9000185106Medicaid
OH0460508Medicaid
IN300055107Medicaid
WI1538799358Medicaid