Organization
SMG/SANTUCCI - UPMC - SHADYSIDE
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
MR. KENNY HEINE (DIRECTOR OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
580 S AIKEN AVE, SHADYSIDE PLACE BLDG SUITE 300, PITTSBURGH, PA 15232-1531
(412) 687-5040
Mailing address
5810 NANCY RIDGE DR, 100, SAN DIEGO, CA 92121-2834
(858) 625-2990
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
MD030965E
PA
Other
Enumeration date
02/09/2007
Last updated
08/02/2010
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