Organization
HEALTHEAST CARE SYSTEM
Active
Organization
HEALTHEAST CARE SYSTEM
Active
Parent organization
MEDVANTX, INC.
Other names
HealthEast - Midway Clinic
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
1690 UNIVERSITY AVE W, SUITE 570, SAINT PAUL, MN 55104-3723
(651) 232-4800
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
(858) 625-2990
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
PY32377
MN
Other
Enumeration date
03/19/2008
Last updated
10/22/2012
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