Basic Information
| Provider Information | |||||||||
| NPI: | 1386604320 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | GENZYME CORPORATION | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | GENZYME CORPORATION ON BEHALF OF ITS GENETICS BUSINESS UNIT | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3400 COMPUTER DR | ||||||||
| Address2: | |||||||||
| City: | WESTBOROUGH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 015811771 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088989001 | ||||||||
| FaxNumber: | 5083895518 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 VIVIGEN WAY | ||||||||
| Address2: | |||||||||
| City: | SANTA FE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 875055600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5054381111 | ||||||||
| FaxNumber: | 5054381120 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2006 | ||||||||
| LastUpdateDate: | 04/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | HART | ||||||||
| AuthorizedOfficialFirstName: | JON | ||||||||
| AuthorizedOfficialMiddleName: | L. | ||||||||
| AuthorizedOfficialTitleorPosition: | SENIOR VP AND GENERAL MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5088989001 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | Y | Laboratories | Clinical Medical Laboratory |
ID Information
| ID | Type | State | Issuer | Description | K4692 | 05 | NM | MEDICAID |