Organization
SUN CITY WEST MEDICAL ASSOCIATES
Active
Parent organization
MEDVANTX, INC.
Other names
Grand Medical Associates
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
14674 W MOUNTAIN VIEW BLVD, SUITE 200, SURPRISE, AZ 85374-2706
(623) 544-6860
Mailing address
9276 SCRANTON RD, SUITE 100, SAN DIEGO, CA 92121-7701
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
25498
AZ
Other
Enumeration date
03/18/2014
Last updated
05/13/2016
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