# WHITEHOUSE STATION FAMILY MEDICINE P A

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MEDVANTX INC.
- **Other names:** Whitehouse Station Family Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1770827982
- **Legal business name:** MEDVANTX INC.
- **Authorized official:** KENNY HEINE (VP OPS)
- **Authorized official phone:** (858) 964-1506

## Contact information

- **Practice address:** 263 MAIN ST, WHITEHOUSE STATION, NJ 08889-3737
- **Practice address phone:** (908) 534-2249
- **Mailing address:** 5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | 25MA037898 | NJ | Yes |

## Other

- **Enumeration date:** 11/15/2012
- **Last updated:** 11/15/2012