Organization
HERITAGE VALLEY HEALTH SYSTEM - TRISTATE MEDICAL
Active
Parent organization
MEDVANTX, INC.
Other names
HERITAGE VALLEY MEDICAL GROUP - PRIMARY CARE CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OPS)
(858) 964-1508
Entity
Organization
Contact information
Practice address
3468 BRODHEAD RD, MONACA, PA 15061-3149
(724) 857-0591
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
OS013323
PA
Other
Enumeration date
08/03/2012
Last updated
10/25/2012
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