Organization
MEDICAL ASSOCIATES OF ERIE INC.
Active
Parent organization
MEDVANTX, INC.
Other names
LECOM INSTITUE FOR SUCCESSFUL AGING
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OPS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
5401 PEACH ST, 3RD FLOOR, ERIE, PA 16509-2601
(814) 868-7850
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
OS014134
PA
Other
Enumeration date
05/21/2012
Last updated
06/13/2014
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