Organization
MERCY MEDICAL GROUP, INC.
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
3160 FOLSOM BLVD, 1ST FLR, SACRAMENTO, CA 95816-5219
(916) 733-3333
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
G62396
CA
Other
Enumeration date
04/23/2008
Last updated
06/21/2013
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