| NPI | 1104446798 |
|---|---|
| Doing Business As | IGENOME HEALTH |
| Entity Type | Organization |
| Authorized Contact | YU SONG Pharmacist In Charge 267-896-2176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2020-04-23 |
| Last Update Date | 2020-04-23 |