NPIMap

Organization Active NPI

Medvantx,Inc.

  • Non-Pharmacy Dispensing Site
  • Duncansville, PA
National Provider Identifier
1386785517
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
MD419838 Issued in PA
Legal business name
MEDVANTX,INC.
Practice address
111 Deville Drive
Box 1077
Duncansville, PA 16635
Phone
(814) 693-0628
NPI assigned
Feb 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kenny Heine
Title
Dir. of Operations
Phone
(858) 625-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X MD419838 PA Primary

Addresses

Primary practice location

111 Deville Drive
Box 1077
Duncansville, PA 16635

Mailing address

5810 Nancy Ridge Dr
Suite 100
San Diego, CA 92121-2834
Phone (858) 625-2990

National Provider Directory

National Provider Directory
Tax ID family
Blair Medical Associati30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386785517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5810 NANCY RIDGE DR",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212834",
            "telephone_number": "858-625-2990",
            "fax_number": "858-625-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DEVILLE DRIVE",
            "address_2": "BOX 1077",
            "city": "DUNCANSVILLE",
            "state": "PA",
            "postal_code": "16635",
            "telephone_number": "814-693-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDVANTX,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIR. OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "MD419838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncansville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.