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Organization

UNIVERSITY MEDICINE FOUNDATION, INC.

Active
Parent organization
MEDVANTX, INC.
Other names
UMF - The Governor Street Primary Care Center
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
285 GOVERNOR ST, 200, PROVIDENCE, RI 02906-3237
(401) 228-3480
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
PA00196
RI

Other

Enumeration date
02/14/2007
Last updated
10/17/2012
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