Organization
ERIE PHYSICIANS NETWORK- UPMC INC
Active
Parent organization
MEDVANTX, INC.
Other names
Pinecrest Family Practice (Pine Avenue)
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
3535 PINE AVE, STE 1, ERIE, PA 16504-1743
(814) 454-3363
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
OS005969L
PA
Other
Enumeration date
02/06/2012
Last updated
05/23/2013
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