Organization
INNOVIS HEALTH
Active
Parent organization
MEDVANTX, INC.
Other names
Innovis Health - South University
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
MR. KENNY HEINE (DIRECTOR OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-3300
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
(858) 625-2990
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
5109
ND
Other
Enumeration date
02/13/2007
Last updated
10/16/2012
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