Organization
WILMINGTON FAMILY PHYSICIANS
Active
Organization
WILMINGTON FAMILY PHYSICIANS
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (SR. DIRECTOR OF OPERATIONS)
85896252990
Entity
Organization
Contact information
Practice address
4141 SHIPYARD BLVD, WILMINGTON, NC 28403-6156
(910) 792-9925
Mailing address
5810 NANCY RIDGE DR, 100, SAN DIEGO, CA 92121-2834
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
31674
NC
Other
Enumeration date
12/24/2009
Last updated
12/24/2009
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