Organization
IGENOME, INC.
Active
Other names
iGenome Health
Organization subpart
No
Provider details
NPI number
Authorized official
YU SONG (PHARMACIST-IN-CHARGE)
(267) 896-2176
Entity
Organization
Contact information
Practice address
1 WORLD TRADE CTR FL 8, LONG BEACH, CA 90831-0002
(267) 896-2176
Mailing address
1835 CHESTNUT ST APT 3R, PHILADELPHIA, PA 19103-3702
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
Other
Enumeration date
04/23/2020
Last updated
04/23/2020
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