Organization
GLADE RUN MEDICAL ASSOCIATES, INC.
Active
Parent organization
MEDVANTX, INC.
Other names
Adult Medicine Associates-Kitanning
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
MR. SCOTT PETERSON (CFO)
(858) 625-2990
Entity
Organization
Contact information
Practice address
300 MEDICAL ARTS BLDG, SUITE 300, KITTANNING, PA 16201-7129
(724) 545-1288
Mailing address
9276 SCRANTON RD, SUITE 100, SAN DIEGO, CA 92121-7701
(858) 625-2990
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
OS016078
PA
Other
Enumeration date
02/06/2007
Last updated
05/03/2017
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