Provider Demographics
NPI:1265196471
Name:SEMA4 OPCO, INC.
Entity type:Organization
Organization Name:SEMA4 OPCO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-298-6470
Mailing Address - Street 1:333 LUDLOW STREET
Mailing Address - Street 2:8TH FLOOR, NORTH TOWER
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902
Mailing Address - Country:US
Mailing Address - Phone:800-298-6470
Mailing Address - Fax:
Practice Address - Street 1:200 E 1ST ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-4165
Practice Address - Country:US
Practice Address - Phone:800-298-6470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
33D2236887OtherCLIA ID #