Organization
NORTH CLINIC, PA
Active
Organization
NORTH CLINIC, PA
Active
Parent organization
MEDVANTX, INC.
Other names
North Clinic - Robbinsdale
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
5109 36TH AVE N, CRYSTAL, MN 55422-2007
(763) 587-7900
(763) 587-7989
Mailing address
9276 SCRANTON RD, SUITE 100, SAN DIEGO, CA 92121-7701
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
33827
MN
Other
Enumeration date
11/26/2008
Last updated
12/29/2022
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