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Organization
JERSEY SHORE MONMOUTH FAMILY MEDICINE GROUP PC
Active
Organization
JERSEY SHORE MONMOUTH FAMILY MEDICINE GROUP PC
Active
Parent organization
MEDVANTX, INC
Other names
Meridian JS Monmouth Family Medicine Group at Howell Jackson Medical C
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
27 S COOKS BRIDGE RD STE 2-3, JACKSON, NJ 08527-2462
(732) 987-5545
(732) 987-5549
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
25MA09443900
NJ
Other
Enumeration date
10/14/2014
Last updated
09/28/2022
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