Organization
LOURDES MEDICAL ASSOCIATES PA
Active
Parent organization
MEDVANTX, INC.
Other names
LMA Cherry Hill Family and Internal Medicine
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
101 BARCLAY PAVILION W, CHERRY HILL, NJ 08034-2139
(856) 429-4179
Mailing address
9276 SCRANTON RD, SUITE 100, SAN DIEGO, CA 92121-7701
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
25MA06291300
NJ
Other
Enumeration date
12/20/2013
Last updated
12/02/2015
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