Organization
ATLANTICARE PHYSICIAN GROUP PA
Active
Parent organization
MEDVANTX, INC,
Other names
AtlantiCare Urgent Care Egg Harbor
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
2500 ENGLISH CREEK AVE, BLDG 900 SUITE 909, EGG HARBOR TOWNSHIP, NJ 08234-5549
(609) 407-2273
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
25MA04005400
NJ
Other
Enumeration date
03/03/2015
Last updated
03/03/2015
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