Organization
FAYETTE PHYICIANS NETWORK INC
Active
Parent organization
MEDVANTX INC
Other names
Fayette Phyicians Network-Uniontown
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
201 MARY HIGGINSON LN, SUITE1, UNIONTOWN, PA 15401-2658
(724) 430-5940
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
MD441591
PA
Other
Enumeration date
03/12/2015
Last updated
03/13/2015
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