Organization
FAMILYCARE MEDICAL GROUP PC
Active
Parent organization
MEDVANTX, INC.
Other names
FCMG- Community Medical 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
18 WELLS RD, AURORA, NY 13026-8724
(315) 364-3388
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
209196
NY
Other
Enumeration date
04/03/2014
Last updated
04/03/2014
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