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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