Organization
SHERWOOD FAMILY MEDICINE
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (SR. DIRECTOR OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
20015 SW PACIFIC HWY, SUITE 300, SHERWOOD, OR 97140-9316
(503) 625-2848
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
MD23583
OR
Other
Enumeration date
07/29/2010
Last updated
10/23/2012
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