Organization
CONEMAUGH HEALTH INITITAVES
Active
Parent organization
MEDVANTX, INC.
Other names
CHI Berkley
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OPERATIONS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
1 TECH PARK DR, 1ST FLOOR, JOHNSTOWN, PA 15901-2515
(814) 288-4488
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
MD069402L
PA
Other
Enumeration date
10/09/2008
Last updated
01/12/2016
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