1538799358 NPI number — SCIPHER MEDICINE CORPORATION

Table of content: (NPI 1538799358)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538799358 NPI number — SCIPHER MEDICINE CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SCIPHER MEDICINE CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538799358
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 412849
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02241-2849
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
855-724-7437
Provider Business Mailing Address Fax Number:
833-643-1004

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
302 E PETTIGREW ST STE A100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27701-2393
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
855-724-7437
Provider Business Practice Location Address Fax Number:
833-643-1004
Provider Enumeration Date:
01/21/2020

Additional Information

Authorized Official

Authorized Official Last Name:
SEETO
Authorized Official First Name:
REGINALD
Authorized Official Middle Name:
KIM
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
855-724-7437

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7100764590 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1538799358 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3944901 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 003277280A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 092275 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1538799358 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9000185106 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0460508 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 300055107 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1538799358 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




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