Organization
ATLANTICARE PHYSICIAN GROUP PA
Active
Parent organization
MEDVANTX, INC.
Other names
AtlantiCare Urgent Care - Little Egg Harbor
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
459 ROUTE 9 S, LITTLE EGG HARBOR TWP, NJ 08087-2225
(609) 407-2273
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
25MA05773200
NJ
Other
Enumeration date
05/06/2016
Last updated
05/06/2016
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