Organization
UNITED MEDICAL PC
Active
Parent organization
MEDVANTX, INC.
Other names
United Medical- Bayonne
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
988 BROADWAY, SUITE 201, BAYONNE, NJ 07002-4036
(201) 339-6111
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
25MA04562300
NJ
Other
Enumeration date
02/06/2014
Last updated
02/06/2014
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