Organization
ALTRU FAMILY MEDICINE CENTER
Active
Parent organization
MEDVANTX, INC.
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
1380 S COLUMBIA RD, GRAND FORKS, ND 58201-4059
(701) 795-2230
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
(858) 625-2990
(858) 625-2999
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
5809
ND
Other
Enumeration date
02/06/2007
Last updated
10/16/2012
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