Provider Demographics
NPI:1699503060
Name:PRECISION EPIGENOMICS INC.
Entity type:Organization
Organization Name:PRECISION EPIGENOMICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-372-7522
Mailing Address - Street 1:630 N. ALVERNON WAY
Mailing Address - Street 2:SUITE 280B
Mailing Address - City:TUSCON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1816
Mailing Address - Country:US
Mailing Address - Phone:520-372-7522
Mailing Address - Fax:520-777-7367
Practice Address - Street 1:630 N. ALVERNON WAY
Practice Address - Street 2:SUITE 280B
Practice Address - City:TUSCON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1816
Practice Address - Country:US
Practice Address - Phone:520-372-7522
Practice Address - Fax:520-777-7367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic PathologyGroup - Single Specialty