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General NPI Number Information
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NPI Number | 1902474653
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Entity Type | Organization
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Legal Business Name | SEMA4 OPCO, INC
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Dates
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Enumeration Date | 06/17/2021
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Last Update Date | 08/31/2022
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Provider Practice Location Address
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Address Line | 62 SOUTHFIELD AVE
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City | STAMFORD
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State | CT
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Zip | 06902-7229
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Country | US
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Telephone | 800-298-6470
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Fax |
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Provider Business Mailing Address
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Address Line | 333 LUDLOW ST FL TOWER8
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City | STAMFORD
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State | CT
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Zip | 06902-6987
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Country | US
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Telephone | 475-333-3621
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Fax | 475-333-3810
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Authorized Official
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Title or Position | PAYOR ANALYST
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Name | DANIELLE WATIMAR
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Credential |
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Telephone | 240-429-3142
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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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