Organization
FAMILY CARE MEDICAL GROUP PC
Active
Parent organization
MEDVANTX, INC
Other names
My Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
1304 BUCKLEY RD, SUITE 302, SYRACUSE, NY 13212-4311
(315) 671-5790
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
206570
NY
Other
Enumeration date
09/12/2014
Last updated
09/12/2014
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