Organization
INTERNAL MEDICINE
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (SR DIRECTOR OPS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
24 DOCTORS LANE, 201, PITTSBURGH, PA 15220
(814) 226-6070
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
OS010436L
PA
Other
Enumeration date
10/19/2011
Last updated
10/23/2012
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