Organization
WHITEHOUSE STATION FAMILY MEDICINE P A
Active
Parent organization
MEDVANTX INC.
Other names
Whitehouse Station Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX INC.
Authorized official
KENNY HEINE (VP OPS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
263 MAIN ST, WHITEHOUSE STATION, NJ 08889-3737
(908) 534-2249
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
25MA037898
NJ
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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