Organization
JERSEY SHORE MONMOUTH FAMILY MEDICINE GROUP PC
Active
Parent organization
MEDVANTX, INC
Other names
Meridian JS Monmouth Family Medicine Group at Howell Jackson Medical C
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
27 S COOKS BRIDGE RD STE 2-3, JACKSON, NJ 08527-2462
(732) 987-5545
(732) 987-5549
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
25MA09443900
NJ
Other
Enumeration date
10/14/2014
Last updated
09/28/2022
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