Organization
UPMC COMMUNITY MEDICINE INC
Active
Parent organization
MEDVANTX, INC.
Other names
Herbert C. Bazron, Jr., MD - UPMC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
1789 S BRADDOCK AVE, SUITE 395, SWISSVALE, PA 15218-1842
(412) 241-1111
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
MD034000E
PA
Other
Enumeration date
10/06/2010
Last updated
05/21/2013
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