Organization
CORNERSTONE HEALTHCARE PA
Active
Parent organization
MEDVANTX, INC.
Other names
CornerstoneTotal Family Care
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
1665 WESTBROOK PLAZA DR, WINSTON SALEM, NC 27103-2993
(336) 760-8380
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
9701463
NC
Other
Enumeration date
11/24/2014
Last updated
11/24/2014
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