Beaver Medical Group LP
NPI #1881857597 in Banning, California
Provider Information
- NPI Number
- 1881857597
- Entity Type
- Organization
- Organization Name
- Beaver Medical Group LP
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MEDVANTX INC
- Primary Specialty
- Non-Pharmacy Dispensing Site
- Enumeration Date
- Jul 3, 2008
- Last Updated
- Apr 25, 2013
Practice Location
- Address
- 6109 W RAMSEY ST
- City
- Banning
- State
- California
- ZIP Code
- 92220-3051
- Phone
- (951) 845-0313
Authorized Official
- Name
- KENNY HEINE
- Title
- VP OF OPERATIONS
- Phone
- (858) 625-2990
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-Pharmacy Dispensing Site |
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