Organization
PENNCARE PENNSYLVANIA HOSPITALIST ASSOCIATES
Active
Parent organization
MEDVANTX, INC.
Other names
PennCare - Zubrow, Kershbaum, Cohen
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (DIRECTOR OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
801 SPRUCE ST, 3E, PHILADELPHIA, PA 19107-5701
(215) 829-8484
Mailing address
5810 NANCY RIDGE DR, 100, SAN DIEGO, CA 92121-2834
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
MD010417E
PA
Other
Enumeration date
02/09/2007
Last updated
11/04/2009
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