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Organization
MEDIGRADE LLC
Active
Organization
MEDIGRADE LLC
Active
Other names
ClubRxPro
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD HEIMANN MD (MEDICAL DIRECTOR)
(818) 371-9466
Entity
Organization
Contact information
Practice address
1889 N RICE AVE STE 201, OXNARD, CA 93030-7989
(833) 702-5508
Mailing address
1309 COFFEEN AVE STE 4515, SHERIDAN, WY 82801-5777
(833) 702-5508
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
09/26/2024
Last updated
09/26/2024
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