Organization
CONEMAUGH HEALTH INITIATIVES
Active
Parent organization
MEDVANTX, INC.
Other names
CHI Portage Health Center
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
3670 PORTAGE ST, SUITE 105, PORTAGE, PA 15946-6546
(814) 736-9614
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
(858) 625-2990
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
OS011062L
PA
Other
Enumeration date
02/12/2007
Last updated
04/24/2013
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