Organization
TOMMY L LOUISVILLE MD PA
Active
Parent organization
MEDVANTX, INC
Other names
First Help Urgent Care Polk City
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC
Authorized official
KENNY HEINE (VP OF OPERATONS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
235 N COMMONWEALTH AVE, POLK CITY, FL 33868-8821
(863) 984-8000
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
ME91882
FL
Other
Enumeration date
07/25/2014
Last updated
07/25/2014
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