Organization
FAMILY HEALTHSERVICES MINNESOTA, P.A.
Active
Parent organization
MEDVANTX, INC.
Other names
FHSM - Maplewood
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (DIR. OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
1814 N SAINT PAUL RD, MAPLEWOOD, MN 55109-4700
(651) 777-8393
Mailing address
5810 NANCY RIDGE DR, SUITE 100, SAN DIEGO, CA 92121-2834
(858) 625-2990
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
28848
MN
Other
Enumeration date
02/13/2007
Last updated
11/04/2009
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