Organization
OSTEOPATHIC INTERNAL MEDICINE
Active
Parent organization
MEDVANTX INC
Other names
PLAZA 38 MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX INC
Authorized official
KENNY HEINE (VP OPS)
(858) 964-1508
Entity
Organization
Contact information
Practice address
2010 W 38TH ST, 1, ERIE, PA 16508-2004
(814) 868-5481
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
OS003106L
PA
Other
Enumeration date
05/21/2012
Last updated
10/25/2012
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