Healthcare Provider Details

I. General information

NPI: 1407314594
Provider Name (Legal Business Name): PRESCIENT MEDICINE HOLDINGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2019
Last Update Date: 03/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E JEFFERSON ST STE 309
LOUISVILLE KY
40202-1279
US

IV. Provider business mailing address

1214 RESEARCH BLVD STE 1000
HUMMELSTOWN PA
17036-9160
US

V. Phone/Fax

Practice location:
  • Phone: 502-625-6013
  • Fax:
Mailing address:
  • Phone: 717-974-4444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KERI J DONALDSON
Title or Position: CEO
Credential:
Phone: 717-974-4444