Organization
LOURDES MEDICAL ASSOCIATES, PA
Active
Parent organization
MEDVANTX, INC
Other names
LMA Family Practice of Moorestown
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
728 MARNE HWY, SUITE 100 B, MOORESTOWN, NJ 08057-3128
(856) 235-6600
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
25MB04640900
NJ
Other
Enumeration date
05/31/2013
Last updated
05/31/2013
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