Organization
SAMARITAN FIRSTCARE PHYSICIANS
Active
Parent organization
MEDVANTX, INC.
Other names
Samaritan Mid-Valley Internal Medicine & Pediatrics
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
400 NW HICKORY AVE, 300, ALBANY, OR 97321-1700
(541) 812-5700
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
MD24253
OR
Other
Enumeration date
01/08/2009
Last updated
10/23/2012
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