Organization
FAMILY MEDICINE CENTER
Active
Parent organization
MEDVANTX, INC.
Other names
FAMILY MEDICINE CENTER - LITTLE EGG HARBOR
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OPS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
279 MATHISTOWN RD, LITTLE EGG HARBOR TWP, NJ 08087-4021
(609) 296-1101
Mailing address
5626 OBERLIN DR, 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
25MB052176
NC
Other
Enumeration date
12/14/2012
Last updated
12/14/2012
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