Organization
FIRST CARE MEDICAL GROUP INC
Active
Parent organization
MEDVANTX, INC.
Other names
FIRST CARE MEDICAL GROUP- LYNDHURST
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OPS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
750 VALLEY BROOK AVE, LYNDHURST, NJ 07071-1301
(201) 896-0900
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
25MA04732500
NJ
Other
Enumeration date
03/01/2013
Last updated
03/01/2013
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