Organization
DEER LAKES MEDICAL ASSOCIATION
Active
Organization
DEER LAKES MEDICAL ASSOCIATION
Active
Parent organization
MEDVANTX, INC
Other names
Deer Lakes Medical Association - Oakmont
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
222 ALLEGHENY RIVER BLVD, OAKMONT, PA 15139-1848
(412) 767-5387
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
MD053615L
PA
Other
Enumeration date
02/09/2007
Last updated
10/16/2012
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