Organization
LIFECARE MEDICAL ASSOCIATES PC
Active
Parent organization
MEDVANTX, INC.
Other names
Lifecare Medical Associates
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
1991 BALSLEY RD, SENECA FALLS, NY 13148-6725
(315) 539-9229
Mailing address
9276 SCRANTON RD, SUITE 110, SAN DIEGO, CA 92121-7701
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
272179
NY
Other
Enumeration date
06/25/2014
Last updated
12/02/2015
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