Organization
SEWICKLEY PRIMARY CARE, LLC
Active
Parent organization
MEDVANTX,INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX,INC.
Authorized official
KENNY HEINE (DIR. OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
701 BROAD ST, SUITE 4B - 4TH FLOOR, SEWICKLEY, PA 15143-1652
(412) 741-0985
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
MD045483L
PA
Other
Enumeration date
02/14/2007
Last updated
10/17/2012
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