Organization
VANCE FAMILY MEDCINE PA
Active
Parent organization
MEDVANTX, INC.
Other names
Vance Family Medicine
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
381 RUIN CREEK RD, HENDERSON, NC 27536-2932
(252) 430-0666
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
36447
NC
Other
Enumeration date
08/21/2014
Last updated
08/21/2014
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