Organization
PIEDMONT ADULT & PEDIATRIC MEDICINE ASSOCIATES, PA
Active
Parent organization
MEDVANTX, INC.
Other names
Piedmont Adult and Pediatric Medicine Assoc
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
640 SUMMIT CROSSING PL, SUITE 204, GASTONIA, NC 28054-2138
(704) 865-0626
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
9500419
NC
Other
Enumeration date
04/03/2013
Last updated
04/03/2013
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