Organization
LEBANON VALLEY FAMILY MEDICINE INC
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (DIRECTOR OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
1400 S FORGE RD, SUITE 1, PALMYRA, PA 17078-9519
(717) 838-1301
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
MD027353
PA
Other
Enumeration date
07/25/2007
Last updated
10/22/2012
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