Organization
DEER LAKES MEDICAL ASSOCIATION
Active
Parent organization
MEDVANTX, INC.
Other names
Deer Lakes Medical Association - Cheswick
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
MR. KENNY HEINE (DIRECTOR OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
221 RUSSELLTON DORSEYVILLE RD, CHESWICK, PA 15024-2004
(412) 767-5387
Mailing address
5810 NANCY RIDGE DR, SAN DIEGO, CA 92121-2834
(858) 625-2990
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
MD053615L
PA
Other
Enumeration date
02/08/2007
Last updated
06/25/2008
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