Organization
GOLDSBORO MEDICAL CLINIC
Active
Organization
GOLDSBORO MEDICAL CLINIC
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (DIRECTOR OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
2400 WAYNE MEMORIAL DR, SUITE 1, GOLDSBORO, NC 27534-1789
(919) 739-9060
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
9600773
NC
Other
Enumeration date
10/28/2009
Last updated
10/23/2012
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