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General NPI Number Information
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NPI Number | 1164612347
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Entity Type | Organization
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Legal Business Name | BIOSERENITY USA, INC.
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 05/10/2022
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Provider Practice Location Address
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Address Line | 25000 COUNTRY CLUB BLVD SUITE 120
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City | NORTH OLMSTED
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State | OH
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Zip | 44070
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Country | US
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Telephone | 440-845-0022
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Fax |
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Provider Business Mailing Address
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Address Line | 200 CORPORATE PL SUITE 5B
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City | PEABODY
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State | MA
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Zip | 01960-3840
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Country | US
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Telephone | 978-536-7400
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Fax |
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Authorized Official
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Title or Position | VP COMPLIANCE & CONTRACTING
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Name | JANICE SHOCK
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Credential |
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Telephone | 214-532-3757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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