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General NPI Number Information
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NPI Number | 1508215922
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Entity Type | Organization
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Legal Business Name | FOUNDATION MEDICINE, INC.
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 11/10/2020
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Provider Practice Location Address
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Address Line | 7010 KIT CREEK RD
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City | MORRISVILLE
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State | NC
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Zip | 27560-9761
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Country | US
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Telephone | 617-418-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 150 2ND ST
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City | CAMBRIDGE
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State | MA
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Zip | 02141-2115
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Country | US
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Telephone | 617-418-2200
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Fax | 617-418-2290
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Authorized Official
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Title or Position | SENIOR MANAGER, REVENUE
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Name | BAHAREH JAFARI
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Credential |
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Telephone | 781-707-6322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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