Organization
GRACE FAMILY HEALTH, INC.
Active
Parent organization
MEDVANTX, INC.
Other names
GRACE FAMILY HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (SR DIRECTOR OPS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
24910 LAS BRISAS RD, 106, MURRIETA, CA 92562-4010
(888) 390-0401
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
PA20229
PA
Other
Enumeration date
08/03/2011
Last updated
10/23/2012
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