Organization
EASTERN MEDICAL ASSOCIATES
Active
Parent organization
MEDVANTX, INC.
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
2609 MEDICAL OFFICE PL, GOLDSBORO, NC 27534-9428
(919) 734-1779
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
9300226
NC
Other
Enumeration date
10/28/2009
Last updated
12/30/2013
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