Organization
PENNCARE FRENCH CREEK FAMILY MEDICINE
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
824 MAIN ST, 307, PHOENIXVILLE, PA 19460-4478
(610) 933-3182
Mailing address
9276 SCRANTON RD, SUITE 100, SAN DIEGO, CA 92121-7701
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
OS016310
PA
Other
Enumeration date
02/12/2007
Last updated
06/23/2016
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