Organization
ATLANTICARE PHYSICIAN GROUP PA
Active
Parent organization
MEDVANTX, INC.
Other names
AtlantiCare Urgent Care- Galloway Township
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
110 E JIMMIE LEEDS RD, GALLOWAY, NJ 08205-9508
(609) 748-2100
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
25MB05380400
NJ
Other
Enumeration date
04/09/2015
Last updated
04/29/2015
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