Organization
JEFFERSON INTERNAL MEDICINE PC
Active
Parent organization
MEDVANTX, INC.
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
575 COAL VALLEY RD, SUITE 374, CLAIRTON, PA 15025-3730
(412) 469-7744
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
MD039474E
PA
Other
Enumeration date
10/09/2013
Last updated
10/09/2013
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