Organization
NORTH WAKE INTERNAL MEDICINE ASSOCIATES
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (DIRECTOR OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
10000 FALLS OF NEUSE RD, SUITE 201, RALEIGH, NC 27614-7838
(919) 848-6946
Mailing address
5810 NANCY RIDGE DR, SUITE 100, SAN DIEGO, CA 92121-2834
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
200000708
NC
Other
Enumeration date
04/16/2009
Last updated
04/16/2009
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