Organization
PENNCARE-PENNSYLVANIA HOSPITALIST ASSOCIATES
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (DIRECTOR OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
1055 ANDREW DR, B, WEST CHESTER, PA 19380-4293
(610) 436-4448
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
OS004486L
PA
Other
Enumeration date
02/12/2007
Last updated
10/17/2012
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