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Organization
ALBANY FAMILY AND SPECIALTY MEDICINE
Active
Organization
ALBANY FAMILY AND SPECIALTY MEDICINE
Active
Parent organization
MEDVANTX, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC
Authorized official
MR. KENNY HEINE (DIRECTOR OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
1705 WAVERLY DR SE, ALBANY, OR 97322-6952
(541) 967-8221
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
(858) 625-2990
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
MD19565
OR
Other
Enumeration date
02/09/2007
Last updated
10/16/2012
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