Organization
PARTNERS IN FREEDOM LLC
Active
Parent organization
MEDVANTX, INC
Other names
WALL FAMILY MEDICAL
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
2130 HIGHWAY 35, SUITE 324 - 2ND FLOOR, SEA GIRT, NJ 08750-1010
(732) 974-1980
Mailing address
9276 SCRANTON RD, SUITE 100, SAN DIEGO, CA 92121-7701
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
25MA05529400
NJ
Other
Enumeration date
11/19/2010
Last updated
03/01/2016
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