Organization
CLINIC FOR CHEST DISEASES, PLLC
Active
Parent organization
MEDVANTX, INC.
Other names
Clinic For Chest Disease
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
10192 W COGGINS DR, SUN CITY, AZ 85351-3405
(623) 974-2434
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
10116
AZ
Other
Enumeration date
12/11/2013
Last updated
12/31/2013
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