Organization
FAMILY HEALTHSERVICES MINNESOTA, P.A
Active
Parent organization
MEDVANTX, INC.
Other names
Entira Family Clinics - White Bear Lake-Bellaire
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
SCOTT PETERSON (CFO)
(858) 625-2990
Entity
Organization
Contact information
Practice address
3220 BELLAIRE AVE, WHITE BEAR LAKE, MN 55110-5854
(651) 777-8149
Mailing address
9276 SCRANTON RD, SUITE 100, SAN DIEGO, CA 92121-7701
(858) 625-2990
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
45801
MN
Other
Enumeration date
02/14/2007
Last updated
04/11/2017
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