Organization
CAROLINA PARTNERS IN MENTAL
Active
Parent organization
MEDVANTX, INC.
Other names
Carolina Partners of Durham
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATION)
(858) 964-1506
Entity
Organization
Contact information
Practice address
3604 SHANNON RD, SUITE 200, DURHAM, NC 27707-6343
(919) 403-2122
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
31742
NC
Other
Enumeration date
05/20/2014
Last updated
05/20/2014
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