Organization
GOLDSBORO WELLNESS CENTER PA
Active
Parent organization
MEDVANTX, INC.
Other names
Goldsboro Wellness Center
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
2600 US HIGHWAY 70 W, GOLDSBORO, NC 27530-7779
(919) 739-4808
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
30306
NC
Other
Enumeration date
03/11/2014
Last updated
03/12/2014
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