Organization
COOPER FAMILY MEDICINE - MARLTON
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (SR. DIRECTOR OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
1001 LINCOLN DR W STE F, MARLTON, NJ 08053-1534
(856) 810-1800
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
25MB05967900
NJ
Other
Enumeration date
02/14/2007
Last updated
10/17/2012
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